Cass Report

[Elaedith]

The randomised part of the trail is only 24 months follow-up, although it states that there is 'potential for non-randomised open extension according to clinical compassionate care'.

If the protocol is compared with this detailed 2020 consensus statement, some aspects are consistent. However, the consensus statement emphasises the need to look at long-term effects. In Table 2, several of the recommendations with the highest consensus ratings refer to the need need for systematic long-term follow-up.

The trial will almost certainly find long-term effects of puberty suppression on neurological development but there is no way of knowing what happens when children move to cross-sex hormones (which almost all do).

There also doesn't seem to be any consideration of whether children are socially transitioned. Social transition will increase the distress associated with the onset of puberty.

 

[d4m10n]

Rolfe mentioned one way.

Animal studies cannot possibly tell us if the endocrine pathway (blockers followed by synthetic cross-sex hormones) reliably leads to psychosocial benefits for young people.

 

[Ziggurat]

Animal studies cannot possibly tell us if the endocrine pathway (blockers followed by synthetic cross-sex hormones) reliably leads to psychosocial benefits for young people.

Sure, but they can give us a hint about the physical effects of hormone treatments, including any negative ones. If we don't even have a clue about that (and we don't), it's not ethical to administer them even if they provide psychosocial benefits.

In other words, we don't even know enough about their safety to ethically test them on humans this way.

 

[d4m10n]

If we don't even have a clue about that (and we don't), it's not ethical to administer them even if they provide psychosocial benefits.

We do have a clue, though.

The effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria: findings from a large national cohort

Background More young people with gender dysphoria (GD) are undergoing hormonal intervention starting with gonadotropin-releasing hormone analogue (GnRHa) treatment. The impact on bone density is not known, with guidelines mentioning that bone mineral density (BMD) should be monitored without...

www.degruyterbrill.com

 

[Ziggurat]

We do have a clue, though.

We have a clue about one aspect. Does it affect heart health? No clue. Does it affect cancer risk? No clue. Does it affect risk for dementia in old age? No clue. And this isn't a comprehensive list.

We're flying blind here, and we're pretending that we aren't. It's deeply unethical.

 

[d4m10n]

If we're just talking about puberty blockade, we already have loads of useful animal data on point.

The idea that we need to wait until a pubescent test cohort reaches old age strikes me as substantively equivalent to lobbying for a full ban.

 

[Ziggurat]

If we're just talking about puberty blockade, we already have loads of useful animal data on point.

As far as I can tell, all of that data is on neutering dogs, and none of it is on hormone blockers. There's likely some overlap in effects, but there's no reason to assume that they will be identical.

The idea that we need to wait until a pubescent test cohort reaches old age strikes me as substantively equivalent to lobbying for a full ban.

I'm OK with that. But even if you don't want to go that far, there's no justification for deploying this treatment as something other than an experimental treatment, and there's no justification for not doing animal studies, even given their limitations.

 

[d4m10n]

There's likely some overlap in effects, but there's no reason to assume that they will be identical.

Since we're already talking about animal studies, "identical" is an unattainably high bar; dogs don't even process dark chocolate as we do.

there's no justification for deploying this treatment as something other than an experimental treatment

What sort of experiments would you allow? If we're going to test puberty blockade (followed by CSH) then we need to treat at least some willing and properly informed patients in the relevant stages of physical development.

 

[Rolfe]

There have been some animal studies. The results strongly indicated that the drugs are not safe to administer to human beings. However, before rushing ahead to ruin more human lives, it might be a good idea to pursue this aspect further. Half a dozen sheep isn't much of an evidence base.

The other thing that absolutely should be done is to mandate proper follow-up of the people who were already given these drugs to see what happened to them. I understand this was blocked by the relevant medical authorities when Cass tried to investigate this aspect. That should absolutely be sorted out.

In no other aspect of human medicine is it acceptable to give drugs to patients before adequate animal safety data are available. In no other aspect of human medicine would it be acceptable to say, the results of the earlier trial were suppressed by the investigators, so although we strongly suspect the drugs are harmful, we have to go ahead and give them to more patients. (Without having animal studies indicating safety is acceptable.)

It's one thing looking at an absolutely desperate situation such as an aggressive cancer and deciding that although there is clearly a risk, it's worth taking for the possible benefit. But in this case the drugs are to be given to minors, who are physically completely healthy. Also, there is no evidence of long-term benefit. The whole thing is based on a bunch of adolescents who have been coached to declare, give me what I want or I'll kill myself.

There comes a point where the evidence stacking up against a treatment absolutely mandates that it should be stopped. Lobotomy for a start. Trepanning for another. Hell, at one point women were told that no way could they have HRT for menopausal symptoms (despite massive evidence of benefit) because a large study had shown a small but statistically significant rise in the indidence of breast cancer among the treated group. (Now they can't get it because so much of the available supply of the hormones is being consumed by men who want to be women.)

We're way past that in this case, in my opinion. The whole thing is beyond grotesque. It's a collective madness, and the sooner the medical profession comes to its collective senses the better.

 

[Ziggurat]

Since we're already talking about animal studies, "identical" is an unattainably high bar;

"More similar" is not. It is very achievable.

Testosterone and estrogen are not unique to humans. Hell, they aren't even unique to mammals. They are deep vertebrate biology, and even show up in fish. And while I expect sharks and humans to be sufficiently different that a shark model wouldn't be very useful, testing a mammalian animal model is a pretty reasonable ask. So find a mammalian animal model for whom gonadotropin releasing analogues (puberty blockers) actually suppress sex hormone production, and test it to see how that affects their development through puberty. That's what anyone seriously interested in using these drugs on people to halt puberty should be doing.

What sort of experiments would you allow?

Aside from animal models, I would start with children who are already being given puberty blockers for the actual medical condition of precocious puberty. What are the long term effects on them? We don't actually have a lot of data on that. But that's just a first step.

If we're going to test puberty blockade (followed by CSH) then we need to treat at least some willing and properly informed patients in the relevant stages of physical development.

First, almost none of the people who were already given these treatments for gender dysphoria were properly informed. They were routinely told that puberty blockers were reversible. That was always a lie.

Second, these drugs aren't just being administered for gender dysphoria as a clinical trial. That's unconscionable. Even if you think it's worthwhile to run such experiments, they should ONLY be run as experiments, requiring regular thorough follow-ups to monitor medical outcomes. And that has not been happening. Lots of patients are being treated outside clinical trials, many of the clinical trials ONLY measure short term psychosocial outcomes, and of the few that do measure medical outcomes, it's mostly just been bone density measurements. Which matter, but hardly suffice. And NONE of them have been looking at long term outcomes, medical or psychosocial.

 

[Rolfe]

This puberty blocker trial is a wicked betrayal of our children. Wes Streeting must stop it now

How can doctors administer drugs that they know can do long-term harm?

www.telegraph.co.uk

Open Letter to Wes Streeting, Secretary of State

On the Proposed Puberty Blocker Trail

substack.com

Tavistock whistleblowers call for immediate halt to puberty blocker trial

Marcus and Susan Evans Susan and Marcus Evans – two of the first whistleblowers involved in exposing the scandal at the Tavistock’s GenderIdentity Development Service (GIDS) – hav…

genderblog.net

Protecting Puberty Protecting Puberty in Adolescent Development

Memorandum of Understanding

protectingpuberty.com

https://twitter.com/x/status/1992609534771114385

I'm appalled at how many apparently intelligent people don't see the evil in this.

They are going to take ten-year-old girls, who aren't interested in boys or sex yet, who just want to be left in a Never-Never-Land of climbing trees and building meccano dinosaurs, and give them drugs that will almost certainly sterilise them. They will offer them "fertility preservation" - have you any idea the stress that egg harvesting puts on even a post-puberty female body? They're going to offer to stimilate this child's ovaries before she has even started menstruating, and harvest the eggs, with all the risks that entails.

She will not ever be able to orgasm, or indeed experience sexual arousal, as a result of this "treatment". She will not grow to the height she might otherwise have attained. (That will be great when they try to make her look like an actual man, not.) Her bones will not strengthen as they should during puberty, leaving her susceptible to backache, fractures and skeletal malformation. She will lose several IQ points.

And that's before we even start on the heightened risks of cancer, heart attack and stroke. The issues with vaginal atrophy, incontinence and early menopause. (How do you go into menopause before you even start menstruating? This is how.)

And all this to treat - nothing physical. These girls' bodies are healthy. Then have an anxiety disorder, in many cases compounded by being pre-lesbian. They are in no danger of illness if these drugs aren't given. On the contrary, it has been known for a very very long time that the cure for these anxieties is - going through puberty.

This proposal is wicked.

 

[d4m10n]

In no other aspect of human medicine is it acceptable to give drugs to patients before adequate animal safety data are available.

Animal studies mentioned here and the FDA already signed off on this drug for use in humans (along with other GnRH analogs) long before this became a hot button political issue.

So find a mammalian animal model for whom gonadotropin releasing analogues (puberty blockers) actually suppress sex hormone production, and test it to see how that affects their development through puberty.

See link above; animal studies already exist.

 

[Rolfe]

You might look at the indications they approved it for. I'm also not really interested in what the "FDA" thinks when this trial is taking place in Britain.

ETA: I mean this. No drug is approved with a blanket carte blanche to give it to any patient for any indication at all. Certainly not in this country. That's what "off-label" use means. Using it in patients and for indications that it wasn't approved for. Now tell me the exact indications the FDA approved these drugs for, and what restrictions were imposed on the on-label usage.

Now tell me how that means it's OK to give them to physically normal children about to enter normal, normally-timed puberty.

 

[Ziggurat]

Animal studies mentioned here and the FDA already signed off on this drug for use in humans (along with other GnRH analogs) long before this became a hot button political issue.

No. The FDA did not sign off on it for use in humans. They signed off on it for very specific uses in humans. Those used do not include as a treatment for gender dysphoria. That has never been an FDA approved use.

And I don't think the animal studies they did tested the effects of preventing puberty or even just delaying it past the normal developmental window. Which makes sense since that's not what the drugs were meant for or approved for. If they want to use the drugs for that purpose outside clinical trials, they should get FDA approval, which would likely require such testing. It hasn't been done.

 

[Pixel42]

The belief that if a drug is approved for one use it must be safe for all uses is one I've encountered on the other forum I belong to. At first I tried to explain the concept of risk/benefit analysis, and how it might produce different recommendations in different circumstances, without much success. Now I simply point out that, just because it's fine to give insulin to diabetics, that doesn't mean it's also fine to give it to people whose pancreas is not malfunctioning.

 

[Rolfe]

https://twitter.com/x/status/1993020004099670355

 

[d4m10n]

The FDA did not sign off on it for use in humans. They signed off on it for very specific uses in humans.

Was delaying puberty one of them?

 

[Ziggurat]

Was delaying puberty one of them?

Only for precocious puberty, not for regular puberty. The effects of delaying regular puberty are not the same as the effects of delaying precocious puberty.

 

[Rolfe]

Was delaying puberty one of them?

You have to ask? You were puffing that the drugs had been approved, but you didn't know what for?

As far as I am aware, the other indications they are used for at present (although I don't know which have official regulatory approval) are:

• Prostate cancer in men
• Breast cancer in women
• Precocious puberty in children
• Chemical castration of sex offenders
• I have used them off-label as part of diagnostic testing, in very small one-off doses, in (female) adult animals.

We can ignore the sex offenders, because they're not supposed to like it. I have not heard any men complaining about unacceptable side effects from their prostate cancer treatment. I have read individual women complaining of serious side-effects to the point where they were lobbying their oncologists to use alternative treatment options. I have read an article by a "survivor" of treatment for precocious puberty who was part of a group who were complaining that they had suffered long-term health consequences from their treatment and they wish it had never been done to them.

Precocious puberty isn't good in itself though, and neither is breast cancer. You have a risk/benefit calculation to make. That is not the case in normal, healthy children who are merely distressed by the prospect of normal puberty.

Nevertheless, @Emily's Cat has explained the treatment for precocious puberty in other threads. Puberty has two aspects to it, which have to be symchronised. In central precocious puberty they are not, and the drugs are given to delay "central puberty" until the other aspect (adrenal?) has caught up so that it all works together. Two years would be the maximum treatment period. (Even so, many people claim to have suffered damage from this treatment.) Using the drugs on a child going into normal puberty doesn't synchronise the process, instead it destabilises it, blocking the central puberty while the other arm goes ahead. Nobody is going to have a normal puberty after being on "puberty suppressors". Even if they don't progress straight on to cross-sex hormones, as nearly all do.

Does this sound like something that it's a good idea to do to physically healthy children? Even as an experiment? It's like starting a trial of lobotomy on the basis that some people thought it helped at one point, and there was never a properly-designed trial, so we should do one now.

I think @d4m10n is right about one thing. The ridiculously short trial period has two purposes. First, there is no chance that the adverse effects will be identified in that time, partly because they're not even asking about them or testing for them, and partly because most wouldn't be expected to show up until later. So they can side-step that. And secondly, because these zealots running this child abuse ring want to delay the time when they can get back to "treating" all-comers (without any follow-up) as little as possible. They want a green light, and they want it ASAP. They can't countenance the idea of children not being able to be put on this treatment for the next ten years or so while they wait to see if the bone fragility and the IQ drop and the rest of it show up.

 

[d4m10n]

You were puffing that the drugs had been approved, but you didn't know what for?

Occasionally I've been known to pose questions even when I've already linked to the answer.