World Professional Association for Transgender Health (WPATH) Files

Boggles

https://www.boards.ie/discussion/comment/121861352#Comment_121861352

We're not in the US. I'm more concerned about women like Sonia Appleby losing their jobs for expressing concerns about child safeguarding, even though that was her actual job, or Allison Bailey,

We're not in the UK either. What's your point?

volchitsa

https://www.boards.ie/discussion/comment/121861524#Comment_121861524

Because the US was mentioned above, to dismiss the whole issue. But unlike the US, the UK is directly relevant because the HSE not only bases many of its protocols on NHS and NICE procedures but sends patients to the UK for treatment when it doesn't have the capacities itself. Thus Crumlin was hosting NHS/Tavistock consultants coming over to Ireland to hold clinics for children with gender dysphoria instead of sending the children to the Tavistock as it had been previously. That's directly relevant because Sonia Appleby was lead child safeguarding consultant there. There are no comparable links with the US.

Boggles

https://www.boards.ie/discussion/comment/121861371#Comment_121861371

The Environmental lobby left out the fact that they were taking oral contraceptives as well.

One rare complication that can occur from taking hormonal birth control is the development of benign or non-cancerous growths on the liver called hepatic adenomas

I assume you are equally worried about the pill now and all women who take it?

volchitsa

https://www.boards.ie/discussion/comment/121861698#Comment_121861698

The risks to a woman's health from pregnancy are far higher than the risk from the oral contraceptive, except for women with contra indications (such as a previous history of breast cancer), which is why some women are not "allowed" the combined oral contraceptive. And that's without taking into account the consequences of unwanted parenthood.

That's why it was important (but finally inaccurate) to claim that children not given puberty blockers and hormone treatments for their gender dysphoria were more likely to commit suicide. Because, if true, that would have been a good reason for giving puberty blockers, despite the fact that they have not been officially tested and authorised for that indication.

Grayson

https://www.boards.ie/discussion/comment/121860743#Comment_121860743

It seems like a general right wing think tank. The guy who runs it is is a climate change denier, pro fossil fuel, rails against critical race theory and trans people. He also believes in fracking.

https://en.wikipedia.org/wiki/Michael_Shellenberger

The simple fact that it's an org that's called environmental progress and it's publishing stuff about trans people should ring alarm bells.

It's like every other dodgy right wing culture wars think tank out there.

Edited to include link

Boggles

https://www.boards.ie/discussion/comment/121861710#Comment_121861710

The environmental lobby group dishonestly omitted the fact.

Again another red flag.

Piling up now.

volchitsa

https://www.boards.ie/discussion/comment/121861730#Comment_121861730

No idea what you mean. They posted up the report for people to read. Should they have put up caveats as well? Why, when it wasn't a discussion about the oral contraceptive? And, as I said, that is not a relevant comparator anyway because the risk-benefit calculation is so much more clearly in favour of preventing pregnancy.

Any chance you could get back on the other questions you've asked and that I've answered?

volchitsa

https://www.boards.ie/discussion/comment/121861729#Comment_121861729

Far from being a climate change denier, he won a Time Magazine "Heroes of the Environment" award some years back.

He doesn't go with the current group think about the solutions to climate change, for example he is concerned that the "race for renewables" is a solution for wealthy countries that will leave poorer countries even worse off than before. It's a reasonable point. He also thinks - like James Lovelock, inventer of the Gaia Hypothesis, again, not a right wing lobbyist of any sort - that nuclear is a far more environmentally friendly method that many have realised. But yeah, it's so much easier to dismiss him as a right wing crank. That way you don't have to deal with what he actually says.

Boggles

https://www.boards.ie/discussion/comment/121861754#Comment_121861754

They made editorial claims, one of these is the treatment caused cancer.

They dishonestly omitted pertinent information in order to draw a conclusion they wanted.

Do not think that is another red flag?

volchitsa

https://www.boards.ie/discussion/comment/121861798#Comment_121861798

I'm wondering why you think that is a reason to dismiss the actual report, that's all. I understood the original objections by some posters here to the fact that people were posting twitter comments about the report, and not the report itself. But now it seems that the report itself can only be considered when made available by an "approved" whistleblower as well. Which is kind of a contradiction in terms.

(It's also not really pertinent, as I explained - the risk-benefit analysis from the contraceptive pill for women or girls at risk of pregnancy is not at all the same as puberty-blockers or cross sex hormones given to healthy teenagers)

Gentlemanne

If this report reveals that trans people aren't getting the adequate healthcare they need, then I agree we should work on improving that standard :^)

ceadaoin.

https://www.boards.ie/discussion/comment/121861698#Comment_121861698

"Benign or non cancerous growths". In the instances referenced in the files, they were cancerous (hepatocarcinoma). Bit different. I'm sure you know that liver cancer is a fatal diagnosis for most people and there are known links with testosterone levels.

I actually do think that loads of women aren't informed or aware of the potentially serious side effects of taking the pill. But that doesn't really have anything to do with children being given experimental treatment off label with no knowledge of long term effects does it?

billgibney

But not one of them have changed their sex.

Imagine the cocktail of drugs needed for a man to produce milk and then throw Viagra into the mix.

Nobody with an ounce of responsibility could say the milk produced was good for babies.

Nothing to do with trans but with child protection.

Grayson

https://www.boards.ie/discussion/comment/121860826#Comment_121860826

Yep. And there's very little in original post. I went to the page that was linked in the tweet in the OP.

There's a number of articles such as their executive summary which don't actually reference or quote anything.

And then there's the excerpts document. https://static1.squarespace.com/static/56a45d683b0be33df885def6/t/65e6daabe13bf54cc3c829f3/1709628077018/U_WPATHExcerpts.pdf

That's a series of quotes. Some are anecdotal. None provide any context. None are cross linked back to the original source.

The "original source" is this. https://static1.squarespace.com/static/56a45d683b0be33df885def6/t/65e6d9bea9969715fba29e6f/1709627904275/U_WPATH+Report+and+Files.pdf

The document is crazy to put it mildly. All the original documents they reference are in screenshots at the end. So it's not searchable.

they also make huge leaps. In one part, page 47-48, they take quotes from people working with trans people who say that transitioning really helps the mental health of trans people. They then claim that the people are saying they can cure schizophrenia by getting someone to transition. The quotes they use don't support their assumptions. Someone saying that transitioning helps a trans persons mental health is not the same as saying that it cures all mental illnesses. But that's what they say

Numerous studies indicate that many adolescents experiencing adolescent-onset gender dysphoria suffer from multiple psychiatric comorbidities that pre-date the onset of distress about their sex.201,202,203,204 Detransitioner testimony supports the hypothesis that some mentally distressed people could be drawn to self-diagnosing as transgender after being led to believe that sex-trait modification procedures are a miracle cure for all their psychological suffering.................

...................................

.................Suggesting that hormonal and surgical sex-trait modification interventions can improve depression, PTSD, and even schizophrenia is a breach of the requirement to present accurate information to the patient when obtaining informed consent. It is akin to a cosmetic surgeon telling a patient that a nose job is the remedy for depression or breast augmentation is the cure for bipolar disorder.

Nothing they say supports this. I've read only a few pages but it's all along those lines. Take something and make a huge leap in logic.

Shoog

https://www.boards.ie/discussion/comment/121861987#Comment_121861987

Child protection involves giving the treatment their doctor prescribed, and if that is for gender dymorphism puberty blockers and transitioning are treatments qualified doctors commonly prescribe.

To deny such treatments is a child protection issue.

billgibney

You obviously didn't read my post

I didn't mention any of the things you mentioned.

Read it slowly and come back to me.

Boggles

https://www.boards.ie/discussion/comment/121861926#Comment_121861926

"Benign or non cancerous growths". In the instances referenced in the files, they were cancerous (hepatocarcinoma).

What page is that on?

Gentlemanne

https://www.boards.ie/discussion/comment/121861926#Comment_121861926

It does matter and the fact you're not able to understand why proves you really only care about this as an angle to attack trans people.

I'm assuming you mean puberty blockers by "experimental treatment off label with no knowledge of long term effects" since that's exclusively what minors receive. Children with precocious puberty take them too, it's hardly off-label or experimental. Unless you're a medical professional familiar with these drugs the language you're using is purely emotional.

It might seem a radical position here but I actually trust doctors and families to make this decision for children in a very tough spot, over the anti-trans cohort who love making it even tougher for those children under the guise of advocacy.

Ash.J.Williams

https://www.boards.ie/discussion/comment/121860063#Comment_121860063

There is a lot on this topic not to be taken seriously

ceadaoin.

https://www.boards.ie/discussion/comment/121862056#Comment_121862056

It is off label, they aren't approved for that purpose. There's already been a class action lawsuit against a drug company by women given blockers to delay their precocious puberty and who suffered all kinds of ill effects in adulthood. And they went through puberty, there is zero evidence about the long term effects of stopping the natural puberty process and replacing it with a cocktail of synthetic cross sex hormones.

Podge_irl

https://www.boards.ie/discussion/comment/121861404#Comment_121861404

Sounds very anecdotal and far from clinical or scientific.

This is the increasingly prevalent consensus on current treatment methods also. This is why English, Finnish, Sweden and some others who have conducted systemic reviews have generally rowed back on following WPATH guidance. Not because they think it is necessarily wrong, just that it lacks the evidential basis required of other medical treatments.

Generally speaking, it takes two sides to fight a culture war. There is a lot of heat and not much light often brought to the discussion, but the need for some systemic and properly controlled testing seems pretty clear.

Podge_irl

https://www.boards.ie/discussion/comment/121862056#Comment_121862056

it's hardly off-label

It is, quite literally, off-label and not advised by the manufacturer.

I (largely) trust doctors too. But there is a standard of evidence expected of medical treatments.

CatFromHue

Chemotherapy is very useful in treating cancer but I wouldnt put much faith in it to treat a broken leg so the application the treatment is being used for is important.

Using a puberty blocker for gender dysphoria is a different application than for precocious puberty. In one there is a biological need and the patient comes off the drug so as to have their puberty at a "normal" age. In the other the patient is going on the drug at the age their "normal" puberty starts and stays on indefinitely. In one puberty happens in the other it doesn't so you shouldn't compare them. There is a very good reason any health body that has done a systematic review has moved their use in gender dysphoria back to an experimental only setting as they've gone through the experimental stage to show they're safe and effective to use for that application.

As I've posted earlier in this thread the issue of consent here is a problem as going on a blocker is a life altering decision which has long term consequences. Children and adolescents aren't allowed to make such long term decisions in other aspects of their life as they're just not able to as they're children and adolescents. Members of the WPATH in these files are openly talking about how these kids just don't understand the consequences of this treatment. How can they consent if everyone knows they haven't a clue what they're doing?

Overheal

https://www.boards.ie/discussion/comment/121861926#Comment_121861926

I actually do think that loads of women aren't informed or aware of the potentially serious side effects of taking the pill.

Misogyny?

Quantum Erasure

https://www.boards.ie/discussion/comment/121861284#Comment_121861284

Sounds like you mean ... religious indoctrination

That's what it looks like all-right, reading some of the responses here

timmyntc

https://www.boards.ie/discussion/comment/121862229#Comment_121862229

Posts like this are why boards is dying. You and I and everyone else knows full well that post was not in the slightest bit misogynistic. The pill is prescribed to women, so the only group of people who possibly could be uninformed about it's prescription to them, is... Wait for it... Women!

volchitsa

https://www.boards.ie/discussion/comment/121861999#Comment_121861999

The problem there is your circular logic: the REASON why puberty blockers and transitioning have become a standard treatment is BECAUSE of advice from WPATH. That advice was supposedly based on the best evidence available.

The leaked documents show that people involved with WPATH knew that wasn't true, and that the scientific basis was actually very weak. This matters all the more because puberty blockers have never been properly tested for teenagers with gender dysphoria, and are given off licence as experimental treatments. Not Best Medical Evidence, as would normally be expected.

ceadaoin.

https://www.boards.ie/discussion/comment/121862229#Comment_121862229

What? Only in the sense that medical professionals aren't informing women of these risks and often brush off any concerns and symptoms raised. Same old.

Constantly using tropes like "pearl clutching", and insinuating that women raising concerns are hysterical maude Flanders won't someone think of the children types is certainly coming from a place of not really liking women though. As is lecturing us about our own bodily functions and hormones that you clearly know nothing about. Hope that helps.

Boggles

https://www.boards.ie/discussion/comment/121862685#Comment_121862685

Only in the sense that medical professionals aren't informing women of these risks

Have you citation for this claim?

Enter name here

A better solution for these people suffering would be this site.

https://www.wpanet.org/

Shoog

https://www.boards.ie/discussion/comment/121863175#Comment_121863175

Offensive much.

ceadaoin.

https://www.boards.ie/discussion/comment/121862778#Comment_121862778

Well aside from my actual experience. Here is one

https://pubmed.ncbi.nlm.nih.gov/30031980/#:~:text=At%20the%20same%20time%2C%20research,dissatisfaction%20may%20undergird%20these%20patterns.

Although women in the United States use birth control at high rates, they also discontinue it at high rates, often citing dissatisfaction and side effects. At the same time, research shows that clinicians often neglect to discuss or discursively downplay the importance of side effects in contraceptive counseling. 

And another

https://www.npr.org/sections/health-shots/2014/06/10/320641019/doctors-dont-know-what-women-want-to-know-about-birth-control

And another

https://www.statnews.com/2021/12/06/patients-doctors-clashing-side-effects-hormonal-birth-control/

ceadaoin.

https://www.boards.ie/discussion/comment/121862387#Comment_121862387

I should have said they aren't "BEING informed or MADE aware" of the side effects to make it super duper clear what I meant. Still wouldn't have stopped certain people trying to wilfully misinterpret for some failed attempt at a gotcha moment though I'm sure

Shoog

https://www.boards.ie/discussion/comment/121863415#Comment_121863415

A doctor will highlight the main potential side effects for any medicine.

They will not list the sometimes dozens of rarer side effects that can occur. All medicines have full disclosure of all potential side effects within their packaging.

volchitsa

https://www.boards.ie/discussion/comment/121863508#Comment_121863508

Oh look, a man telling a woman she‘s wrong about her own medical experience. Even when links to studies saying the exact same thing have been provided.

It's quite funny in a way.

Grayson

https://www.boards.ie/discussion/comment/121862395#Comment_121862395

The leaked documents don't show that WPATH knew it wasn't true.

Earlier I actually went and started reading the document that was released with the leaks. I even linked it. Please show me in that document exactly where they state that they knew they weren't working on best evidence. Because if you can't do that, then you're just repeating what others have told you.

Hamsterchops

https://www.boards.ie/discussion/2058339308/world-professional-association-for-transgender-health-wpath-files

Glad you posted this, although as you alluded to, with the wokeism of the day being so pervasive don't expect too much shock or amazement at the findings ......

Some countries like Ireland, New Zealand, Canada, OZ and certain US States are so embroiled & signed-up to the ideology, that no matter what is revealed re kids puberty blockers & "corrective" surgeries, people will still blame the report and not the practice.

Good luck with this thread.

Boggles

https://www.boards.ie/discussion/comment/121863340#Comment_121863340

According to what I could access of that, it basically states some clinicians do not dwell on rare side effects for healthy women.

Which is perfectly reasonable and makes sense, if Doctors started ranting and raving about the rare side effects of Paracetamol no one would take it.

CatFromHue

https://www.boards.ie/discussion/comment/121863921#Comment_121863921

Best evidence shows that children and adolescents can't make long term life changing decisions. I've linked it here already that the Doctors here are encountering this and still continuing. Remember in the latest standards of care the WPATH removed many min age limits for various treatments.

Best evidence is that detransition exists and for most other treatments you'd study where they went wrong to improve the service.

acknowledgment that de-transition exists even to a minor extent is considered off limits for many in our community,” WPATH President Marci Bowers 

Then there's also stuff like this

I’m missing why you are perplexed… The mere presence of psychiatric illness should not block a person’s ability to start hormones if they have persistent gender dysphoria, capacity to consent, and the benefits of starting hormones outweigh the risks…So why the internal struggle as to ‘the right thing to do?’” Dr. Dan Karasic, lead author of WPATH Standards of Care 8 mental health chapter

“It would be great if every patient could be perfectly cleared prior to every surgical intervention, but at the end of the day it is a risk/benefit decision…if the patient can’t follow the dilation schedule, they may lose depth, but as long as they’re capable of making that decision of sound mind while informed of the risks, then that may be all you can do.” Doctor

So you've one doctor saying as long as they're of sound mind the patient knows the risks what happens is down to them and another doctor saying it shouldn't matter if they've psychiatric illness, which I would have thought would limit their capacity to consent.

I've said already this is pointing out that trans healthcare is sub standard and improving it only benefits trans people.

Grayson

https://www.boards.ie/discussion/comment/121864201#Comment_121864201

Except you're wrong. Best evidence shows that teens can make those decisions. Plus you're ignoring the other stuff in that file where they said they wouldn't do anything without parental consent. That's the important thing there. They need a referral from a psychologist and parental consent before any treatment begins. So you're deliberately phrasing it in such a way to imply that there's no medical review and no parental consent needed.

Psychiatric illness should not be a blockage to any treatment. Capacity to consent is what's important. And it specifically mentions that. You can be mentally ill and still be capable of making informed consent. The fact that you've been diagnosed with low level depression does not mean that you can't make an informed decision about your medical treatment. Yes, there will be times when a person is mentally ill and incapable of making a decision, but the fact that there's a mental illness does not automatically disqualify someone. If that was the case no-one who's ever prescribed antidepressants would be able to receive any other medical treatment because according to you they can't consent.

CatFromHue

These are a bit more than low level depression

In reply to a nurse practitioner who is struggling with how to handle a patient with PTSD, major depressive disorder, observed dissociations, and schizoid typical traits who wishes to go on hormone therapy:

“I’m missing why you are perplexed… The mere presence of psychiatric illness should not block a person’s ability to start hormones if they have persistent gender dysphoria, capacity to consent, and the benefits of starting hormones outweigh the risks…So why the internal struggle as to ‘the right thing to do?’”

Dr. Dan Karasic, lead author of WPATH Standards of Care 8 mental health chapter

Mentally ill and homeless people are regarded as suitable for referring for genital surgery: “I have also intervened on behalf of people who have been diagnosed with major depressive disorder, cPTSD, homeless and got at least an orchiectomy… In the last 15 years I had to regrettably decline writing only one letter, mainly b/c the person evaluated was in active psychosis and hallucinated during the assessment session. Other than that - nothing - everyone got their assessment letter, insurance approval, and are living (presumably) happily ever after.”

Gender therapist

Patients with dissociative identity disorder are regarded as having the capacity to consent to hormones:

“One client who had [dissociative identity disorder], we worked on all alters giving consent to HRT before it was started. They had alters who were both male and female gender and it was imperative to get all the alters who would be affected by HRT to be aware and consent to the changes. Ethically, if you do not get consent from all alters you have not really received consent and you could be sued later, if they decide HRT or surgery was not in their best interest.”

Gender therapist

As for whether children and adolescents can consent to this type of treatment I'd very strongly disagree.

Grayson

https://www.boards.ie/discussion/comment/121864289#Comment_121864289

You said psychiatric illness, without qualification. And the part you quoted again still shows that what they're interested in is the capacity to consent. That the presence of a mental illness shouldn't automatically disqualify them. Are you saying that they shouldn't establish the capacity to consent and automatically disqualify everyone?

As for whether children and adolescents can consent to this type of treatment I'd very strongly disagree.

That's nice. let's change the best practice because you disagree.

Whenever they're looking to treat a child or adolescent, the child's wishes should come first and be the biggest factor in making the decision. The parents will listen to what their child says and they will factor that in. Plus you're once again ignoring the fact that parental consent and a referral is needed. So well done, at least you're consistent.

As for patients with DID, did you even read the discussions. They've selectively pasted certain parts of the discussion and left out others. but even with what they left in we can tell it's a discussion about how to approach these types of cases. One of the doctors said that they requested a letter from a DID specialist before considering surgery. Another says that they're complicated cases and there's no single solution.

What it actually shows is doctors doing research on how to approach particularly complicated cases. This isn't a group of people who don't care about their patients. They are looking for the best ways to treat their patients. They're pooling their knowledge and experience so they can offer the best care possible.

Or would you want them not to talk? Not to discuss? Not to ask for advice or share knowledge?

volchitsa

https://www.boards.ie/discussion/comment/121863921#Comment_121863921

Well here you go then.

First, nobody is claiming that they are going around saying "Hee hee hee, we're giving sh1t advice to our patients - but don't tell 'em!"

You need to know is what the current evidence actually says, and when the discussion goes against that without immediately being called out by others as obviously inappropriate, then there's a problem. And in this context it seems to happen because WPATH is more full of activists than objective researchers. So the ideology is given higher priority than the evidence.

For example, from around p117 on, the discussion is about puberty blockers for pre teens. There's a non medical person (psychologist perhaps?) expressing concern about a 10 year old patient being started on these, as approved by their doctor. So a 10 y-o is being given PBs, but if you read on, on P118 Marci Bowers (herself a TW, but who only transitioned in middle age after having had children) says that she is "unaware of anyone claiming ability to orgasm when they were blocked at Tanner 2" , ie started on PBs at Tanner stage 2 when the first signs of puberty are visible, which is the earliest PBs can be given.

Consent needs to be "informed" in order to be valid. How could a 10 year old possibly understand the significance of the ability to reach orgasm in adult relationships? It's not informed consent. That should be a major stumbling block right there. Yet the whole tenor of these discussions is about facilitating surgery, not querying it. In fact, some of the concern expressed is that the mere fact of expressing concern might strengthen "conservative" opposition to the treatments (eg bolded below).

Such as: p158, 159 etc is about "patients who identify as eunuchs", and the sorts of "atypical surgery procedures" which either "don't exist in nature or represent the first of their kind" (I'd like to know the difference there). Another practitioner asks about "gender nullification surgery", and says they have no experience of doing this.

So what research data do you think exists for this "first of its kind" surgery? And yet that doesn't come up in the responses as a major problem. Several replies discuss how best to do it, and about how social responses of shock to this are not important. Nothing about whether the patient has any other mental health issues. If your patient wanted a healthy leg amputated, would the "best evidence" response really be for your colleagues to propose various ways of doing this technically without asking whether there are mental health issues involved? Instead they talk about the risk of "non standard surgery" being "weaponised" by conservatives - that's the biggest risk that presents itself apparently when you operate to make someone "gender nul". That's the talk of activists, not of carers.

Basically, the leaks show clinicians discussing patients receiving irreversible treatments who seem very unlikely to be able to receive informed consent, including some who are very young, and others who have serious mental-health disorders. Some of the conversations suggest that the clinicians themselves don’t know the long-term effects of treatments. In other conversations, it seems that they do know that cross-sex hormones or surgeries are likely to cause serious harm, but advocate for those treatments nonetheless. It suggests that some WPATH members brush off concerns about long-term patient outcomes, despite being aware of potentially debilitating and even fatal side effects of cross-sex hormones and other treatments. 

P88: Another one, about consent for people with known mental health issues: “In the last 15 years I had to regrettably decline writing only one letter, mainly b/c the person evaluated was in active psychosis and hallucinated during the assessment session. Other than that – nothing – everyone got their assessment letter, insurance approval, and are living (presumably) happily ever after.”

“presumably” happy ever after? That's some assumption, surely? No need for follow-up? That's from a gender therapist in California, who also said: “I have also intervened on behalf of people who have been diagnosed with major depressive disorder, cPTSD, homeless and got at least an orchiectomy…”.

So apparently homeless people with major mental disorders can have themselves castrated by removing their testicles. What could possibly be wrong with that? The discussion goes on to reject the very idea of being "a gate-keeper" by withholding treatment until existing MH conditions are "stabilised" - but if an anorexic girl went to a doctor for bariatric surgery, wouldn't that also be "gate keeping" to say that it's not appropriate treatment for her problem?

But of course if you're going to say "Ha, but they don't actually say that they know it's madness to make someone a eunuch just because he asks for that", then sure, you're right. They don't.

But TBH, if that's really your response, then all I can say is, we'll see how this all goes in ten years' time when the massive scandal of mentally ill people being given irreparable major surgery based on a mentally-ill image of themselves, and I'll be interested to see how many people currently nodding along to this will be around either still defending it, or (even less likely) admitting that they got it entirely wrong.

(The discussion around detransitioning is also fascinating, (around p106) and shows, well, several things: the newer problems arising from the fact that the profile of transgender people is so split, with older men transitioning to female and now, recently, young females for the first time wanting to transition to male. Those are the ones who are (according to the discussion, but also, unsurprisingly) expressing regret and wanting help with fertility and often how to detransition.

The split between clinicians who do really seem concerned about their patients above all, and others who say that patients should just take responsibility for their choices, and that even considering detransitioning risks providing a weapon for the bogeymen on the right (again, the need to prioritise the ideology over the people involved) is very noticeable there.

volchitsa

https://www.boards.ie/discussion/comment/121864244#Comment_121864244

How can a child who has never had an orgasm possibly consent to never having an orgasm in their lives?

They don't understand the role that adult sex lives play in a long term intimate relationship, so cannot consent to having a massive aspect of it removed for ever.

Same question concerning future infertility. If you ask a child about the desire to become a parent, chances are they'll say "No I don't ever want to do that." And if you tell them that the price to pay for doing something they really want to do now is that they won't have children later, then it's even more likely that they'll be certain that that's absolutely fine because that's not something they particularly want to do.

That doesn't mean that at 25 or 30 they will still think the same thing. FGS, we don't let them have tattoos for that reason - do you think that's wrong too?

ceadaoin.

Whenever they're looking to treat a child or adolescent, the child's wishes should come first and be the biggest factor in making the decision. The parents will listen to what their child says and they will factor that in. Plus you're once again ignoring the fact that parental consent and a referral is needed. So well done, at least you're consistent.

No, the child's wishes shouldn't come first because they are a child and can't consent. Should we also listen to a child's wishes if they want to have a sexual relationship, get a tattoo or take drugs or alcohol? Should we also let kids let demand whatever medication they want, despite it being inappropriate for their age group? If a kid has anorexia or body dyspmorphia and thinks they should be given a weight loss drug or surgery should we put their wishes first in that case? No, that would be ridiculous. This notion that kids should be able to consent to actions that have such long lasting consequences that they can't possibly understand is extremely creepy.

Shoog

https://www.boards.ie/discussion/comment/121865155#Comment_121865155

Your suggestion is that many/most people seeking treatment have underlying mental health issues driving their desire for treatment. Gender dymorphism is no longer considered a mental health illness and is not treated as such.

Also in Ireland and the UK extensive long term physchological assessment has to be carried out before any gender related treatment is offered or suggested to identify any mental health issues driving or resulting from gender dymorphism.

To be frank you are arguing a straw man as to what actually happens with regard to gender dymorphism treatment, but there is little to surprise me in this.

Arguing from an American perspective where treatment is primarily a profit driven area is deeply disgenious to those operating within the Irish health system where patient welfare is paramount.

Shoog

https://www.boards.ie/discussion/comment/121865778#Comment_121865778

The reality is that most children are very aware of their gender from the age ofaround five, and this includes people who identify as been the opposite gender to their biological sex. Most will not change that identification from that age to adulthood. This is not surprising since they are describing their lived experience of been born into the wrong sexed body for their gender.

How you deal with that up until the age at which they can take full control of their treatment at the ago of consent is really the only issue with regard to children. A parent is in full control of any decisions regarding treatment up until that point.

So what a child says about themselves with regard to gender is vitally important - but all treatment decisions are the parents until the age of maturity.

volchitsa

https://www.boards.ie/discussion/comment/121866045#Comment_121866045

I'm definitely not arguing "from an American viewpoint" - the exact opposite in fact.

I suspect you are using that claim as a way of dismissing a point of view you disagree with, rather than it being something you've actually identified, because I'm at a loss as to why you would think that of my take on these issues.

Tavistock trust whistleblower David Bell: ‘I believed I was doing the right thing’

https://www.theguardian.com/society/2021/may/02/tavistock-trust-whistleblower-david-bell-transgender-children-gids

The psychiatrist behind a critical report on the gender identity unit at the NHS trust on the efforts to silence him and his concerns about children’s access to treatment

I'm more influenced by people like Dr David Bell, former governor of the Tavistock clinic, quoted above. In fact it was his interventions that started alarm bells ringing for me. Because he is a medical professional, and not a right/left political ideologue - which is far more the US position on this issue.

It is a UK-centred report, since it's about GIDS/Tavistock, but as the HSE takes its lead directly from the Tavistock, it's directly applicable to clinical practices in Ireland too.

There's also this, rather more theoretical, publication by Dr Bell, entitled "First, do no harm":

https://www.maudsleyphilosophygroup.org/wp-content/uploads/2022/11/First-do-no-harm-IJPA.pdf

He analyses the current situation in the UK thus:

I think that in our current conjuncture we are witnessing a growing misogyny. What I have in mind here is this: from World War II up until the late 1970s a strong femininity, expressed by the increasing theorisation and respect for maternal caring, and in the British context the creation of the Welfare State, maintained a certain social dominance. However, that version of strong caring has been re-presented in its perverse form, the “nanny state”, a contemptuous attack on femininity. This is both expressed and reinforced by ideological forms that promote the delusion of the autonomous man, seeking to service only his own needs, enacting a hatred of all forms of dependence. This growing misogyny may be having profound effects on girls and, in conjunction with more individual factors, supports the internalisation of this hatred of femininity, transformed into a hatred of their female bodies. The internet/social media are major determining forces, occupying a position that is both causal and also the vehicle for other causes. Through a kind of viral social contagion, children who feel lost in the world become radicalised online, join trans groups that provide them at last with an identity and social belonging

Again, not a hint of the US culture wars approach to it.

volchitsa

https://www.boards.ie/discussion/comment/121866119#Comment_121866119

This claim makes very little sense in terms of what we know about childhood development though.

Adolescence is when the sense of personal identity develops, not before that. There is no theory of child development which identifies the existence of a strong sense of personal identity before that.

This is why adolescence is the time when young people "try out" different identities, like being a goth or whatever, particularly identities different from those society or their family expect of them.

It's also why talking about "trans kids" is misleading. To quote David Bell again, they are children with gender dysphoria (often accompanied by mental health issues of varying severity). Some may persist past adolescence and become transgender adults, but most will desist. And the problem is that there are really only statistical measures of who will persist and who will not. So it's impossible to identify the minority for whom going straight onto the pathway of blocking puberty (that period that allows a sense of self to develop fully) might work out well because that was where they were going to be anyway.

For the rest, the majority, taking puberty blockers is more likely to stop the sense of self from developing, IOW to "block" the child in their gender dysphoria. And there is no certain measure to identify which child/teen belongs in which of those two groups.

No. I don’t think it’s helpful to ever call a child a trans child. I think we should say it’s a child with problems who is expressing themselves in a particular way that needs understanding and may become a trans person and may not. But once you call them a trans child, you’re doing what we call foreclosure rather than exploring.

They now realise that they were expressing their difficulties with their sexual body through calling themselves to the other sex. That was supported culturally and socially and also by the clinic that they attended. And they now feel that that was a terrible mistake. As one young woman put it to us, I look in the mirror. I do not see a male body. I see a mutilated female body.

And that is what WPATH tends to elide - as the files show. That fundamental problem of the very idea of a "trans child", as opposed to a child with gender issues, which may in fact be more the reflection of other issues the child has, and not an actual "trans identity".

volchitsa

https://www.boards.ie/discussion/comment/121866119#Comment_121866119

https://www.boards.ie/discussion/comment/121866045#Comment_121866045

Also I've just noticed: what do you mean by "gender dymorphism"? I don't know what that is, but I first read it as gender dysphoria. If it's something else, could you explain please?

Secondly, can you explain how someone could be "born into the wrong-sexed body"? What part of them is the "right-sexed" part? Their brain? How does that show up? Can we identify it at all or do we have to prescribe drugs and/or surgery based on what the person says?

In which case, should we also prescribe weight loss drugs for the same reason? (The person may genuinely feel obese, even though they are only slightly over the normal weight for their age/height?) Or does this only work for sex? If someone is born blind, were they born with the "wrong" eyes?