Interesting that Alejandra Caraballo has repeated on Bluesky the false claim that the Cass review rejected nearly all studies for not being blinded RCTs, along with the screenshot that is compiled from the 2020 NICE review, not the final 2024 Cass review. The original claim was made on Twitter/X in April 2024 shortly after the publication of the Cass review. From what I can see, it appears to have been posted on Bluesky 27 days ago, unless I am misunderstanding something. The archive note says the post was first made in April but was first seen on Bluesky in November. I don't think there can be any doubt that Caraballo knows the claim to be false by now.
Cass Report
- Thread starter d4m10n
- Start date
Louden Wilde
Muse
NYT notes in their reporting today on the (US) Supreme Court & the Tennessee Law on "gender-affirming" Care:
"Most doctors in the United States support gender treatments for adolescents, based on guidelines written by professional medical groups. But in Europe, countries including Sweden, Finland, Norway and Britain have limited gender-related medical treatments for teenagers after scientific reviews that found weak evidence of long-term benefits.....In Britain, restrictions on access to medical treatments for minors followed a yearslong review of the medical evidence by Dr. Hilary Cass, one of the country’s leading pediatricians. Her final report concluded that the evidence supporting the use of puberty-blocking drugs and other hormonal medications in adolescents was “remarkably weak.”
"Most doctors in the United States support gender treatments for adolescents, based on guidelines written by professional medical groups. But in Europe, countries including Sweden, Finland, Norway and Britain have limited gender-related medical treatments for teenagers after scientific reviews that found weak evidence of long-term benefits.....In Britain, restrictions on access to medical treatments for minors followed a yearslong review of the medical evidence by Dr. Hilary Cass, one of the country’s leading pediatricians. Her final report concluded that the evidence supporting the use of puberty-blocking drugs and other hormonal medications in adolescents was “remarkably weak.”
d4m10n
Penultimate Amazing
It might well be noted that the evidence will remain remarkably weak in the U.S. if half the states follow the example of Tennessee while the other half uncritically adopt the endocrine pathway without ever requiring trials to be run, that is, studies randomly assigning some patients to other treatment modalities.
From the NYT article: "The main evidence of the care’s benefits comes from a small study from a clinic in the Netherlands in the 1990s, which found that teenagers who medically transitioned experienced long-term mental health gains. " The problems with these studies were already discussed previously in another thread. This is a good analysis.
People who didn't like the conclusions of the Cass report nitpick over methodology but provide no new facts or analysis.
Yes and the evidence is unlikely to ever convince anyone. As far as I can tell, just about everyone has already made up their minds including the folks that could most be relied to actually do the studies. To be clear, I think some folks are ideologically captured on both sides of this issue. Maybe someone in Europe can actually provide good evidence one way or the other but as far as I can tell, not in the US.
d4m10n
Penultimate Amazing
Subjects who survived the process of transition experienced those gains; at least one died as a result of gender affirming surgery.
This is just crazy, though. It is nigh impossible to point to a single study which randomly assigned some juvenile patients to talk therapy (attempting to adjust their minds to come to terms with their changing bodies) and randomly assigned other juvenile patients to the new and completely different treatment modality (attempting to adjust their bodies to fit their desired self image). Tavistock—to take one prominent example—literally flipped from one approach to the opposite approach without ever once scientifically studying which approach yields better results.
Emily's Cat
Rarely prone to hissy-fits
Humorous sidebar to a serious discussion...
Three times in a row I read this as "No-one at all".
d4m10n
Penultimate Amazing
I did too! Then I had to Google b/c I thought we were being punked.
angrysoba
Philosophile
I think the Cass Report actually did change a lot of minds or at least settle questions that they may have had about the efficacy of the treatments on gender dysphoria and mental health outcomes. I think it won’t settle anything in the US though.
d4m10n
Penultimate Amazing
I would argue that the report is much more unsettling than settling; the overall thrust is that we don't have enough evidence yet to say which treatments are best for the (rapidly expanding) clinical population being treated.
angrysoba
Philosophile
Possibly unsettling in more than one way.
Speaking of which, Jesse Singal has a new article out on the Economist about how "America’s best-known practitioner of youth gender medicine is being sued".
Link
It's paywalled, so you may have to get an account to read either a small number of free articles a month, or of course subscribe and read more.
If you want to see more about the story he's also decided to put more details up on... Bluesky. Which hasn't gone down well with many of the residents there.
d4m10n
Penultimate Amazing
I thought he was kicked off today. 
Louden Wilde
Muse
It's the Odysseus strategy!
Pixel42
Schrödinger's cat
The most unsettling part is that the organisation that had (or at least should have had) a lot of such evidence refused to hand it over to Cass, despite being ordered to do so by NHS England.
Matthew Best
Penultimate Amazing
Seems to still be there, but the replies to just about anything he posts are something to see. It's kind of weird seeing how intolerant people are when they see someone who they accuse of being intolerant.I thought he was kicked off today.
angrysoba
Philosophile
I think his account or profile was briefly put into some kind of moderation then restored. So he is now free to have untold numbers of posts telling him to eat various forms of bodily excretions and sexual organs. I mean, his opponents don’t seem to be putting forward arguments that put themselves in a good light. I think someone should point that out to them.
Singal's article is available on archive.is.
Olson-Kennedy, is the same doctor who recently said she doesn't want to publish the results of a major long-term study into puberty blockers because the findings don't show mental health benefits. (This is available on archive.is too).
Pixel42
Schrödinger's cat
Interesting BBC article on the ethics of the forthcoming clinical trial of puberty blockers recommended by Cass.
Puberty blockers: Can a drug trial solve the big debate?
The government has pledged to determine the evidence - and establish whether the benefits outweigh any potential harms of prescribing puberty blockers to children questioning their gender
www.bbc.co.uk
Also talks about it on his podcast blocked and reported. He posted on bluesky and twitter and apparently got the exact results you'd expect both platforms.