Cont: Trans women are not women (IX)

[theprestige]

"But you see, if you stop taking Lupron and your testicular cancer returns, that means its effects are reversible!"

Technically Correct is the worst kind of correct, and the second worst possible basis for public policy towards transsexual accommodation.

 

[Emily's Cat]

The only thing "puberty blockers are reversible" means is that puberty can later be unblocked. Which is true.

Actually, no, it's not true. Not in the way that is implied. What is implied and claimed by trans activists is that the effects of puberty blockers are completely reversible, and if you stop taking them, you will resume a completely normal and complete puberty. And that claim is false. Puberty is a time-bound process. The time that hormone production is interrupted is time that a person doesn't get back.

Now, let's make a very important distinction between these drugs used to curtail and treat precocious puberty - which has the effect of delaying the onset of puberty until the appropriate time frame - and the use of these drugs to "give kids time to decide" in the situation of gender dysphoria. The above comment is related to using these drugs to interrupt normal puberty in children with dysphoria.

You think prescribing puberty blockers to delay precocious puberty has a >95% chance of causing a procession to cross-sex hormones?

No, and that was not what was claimed. The use of these drugs to interrupt a normal puberty in children with dysphoria leads to >95% of them going on to cross-sex hormones (which means they never actually experience puberty). On the other hand, if those children do NOT take puberty interrupting drugs, over 90% of them will find that their dysphoria alleviates as they continue through puberty, and the majority of them will be homosexual. Part of their dysphoria is caused by being gay or lesbian and being uncomfortable with their developing sexuality.

Giving kids puberty interrupting drugs results in the sterilization and permanent medicalization of homosexuals.

 

[Emily's Cat]

Just for absolute clarity, since we're in the world of "technically correct" arguments...

If a female child takes blockers at the onset of puberty, and then moves on to estrogen suppressors and testosterone, that child will NOT experience a male puberty. That child will essentially NOT HAVE PUBERTY. They will gain height, and if the blockers were taken for a very short period of time, they will accrete bone density. And they will acquire some non-sexual characteristics of a normal male such as facial and chest hair, and male-typical distribution of muscle mass. But they will NOT experience the maturation of their sexual organs. And they most definitely will NOT experience the maturation of MALE SEXUAL ORGANS which they don't possess.

The same is true in the other direction.

 

[mumblethrax]

That is literally NOT the most relevant sense.

It is the most relevant sense. That's the primary effect. There's a reason the consequences you're talking about are called side effects.

The fact of having taken puberty blockers isn't the irreversible consequence of interest. That is literally irrelevant to everyone. Stunted growth, impaired cognition, infertility, the inability to experience organsim, these are permanent consequences of taking puberty blockers to halt regular puberty that actually matter.

Puberty blockers don't cause stunted growth. Where did you get that from?

Yes. Every single clinician who claims that they are reversible. I have never seen any exception, and you will not find any exception, because the claim isn't used the way you are trying to argue that it is used.

It took me a matter of seconds to find an exception, from the Pediatric Endocrinology Society: https://pedsendo.org/wp-content/upl...ppression-for-Youth-with-Gender-Dysphoria.pdf

But you're badly misidentifying where the burden of proof lies if you're going to claim that every clinician who says "hormone blockers are reversible" is medically negligent.

 

[Ziggurat]

Puberty blockers don't cause stunted growth. Where did you get that from?

For example:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243894
"Height and weight were normal at baseline. Height growth continued through the study but more slowly than expected for age"

It took me a matter of seconds to find an exception, from the Pediatric Endocrinology Society: https://pedsendo.org/wp-content/upl...ppression-for-Youth-with-Gender-Dysphoria.pdf

No mention of cognitive impairment, no mention of inability to orgasm. It's basically just bone density. Even the infertility thing is only mentioned when combined with "gender affirming" (ie, sex denying) hormone treatment. So yeah, they talk a bit about some of the negative side effects. But they're still very much underselling how big the risk is, and how potentially bad the side effects are.

But you're badly misidentifying where the burden of proof lies if you're going to claim that every clinician who says "hormone blockers are reversible" is medically negligent.

And you've badly misidentified what "reversible" even means, and the fact that there is no proof or even good evidence that they are reversible when used to treat gender dysphoria.

If you stay on these drugs long enough (and many patients do), you never go through puberty at all. Even by your own definition, that's not reversible.

 

[mumblethrax]

FYI, that's actually NOT what the drugs say on the tin. Their approved usage is as treatment for cancer. They are used off-label to block puberty.

No, that's not an off-label usage. They are approved by the FDA for use as puberty blockers.

The most commonly used puberty blocker is Lupron, which was developed to treat testicular cancer, and it blocks the production of sex hormones. It might be useful for you to go look into the side effects of Lupron.

I know what the (known) side effects are.

Actually, no, it's not true. Not in the way that is implied. What is implied and claimed by trans activists [...]

I'm not going to entertain imputed implications about what trans activists say.

No, and that was not what was claimed.

It is what was claimed. And d4m10n has already ceded that point.

Just for absolute clarity, since we're in the world of "technically correct" arguments...

I guess we are in that world, since Ziggurat thinks "actually, puberty blockers aren't technically completely reversible" is an intelligent response to the claim that puberty blockers are reversible.

If a female child takes blockers at the onset of puberty, and then moves on to estrogen suppressors and testosterone, that child will NOT experience a male puberty. That child will essentially NOT HAVE PUBERTY. They will gain height, and if the blockers were taken for a very short period of time, they will accrete bone density.

This is not so much a "technically correct" argument as it is a complete non sequitur.

 

[d4m10n]

Giving kids puberty interrupting drugs results in the sterilization and permanent medicalization of homosexuals.

Big, if true.

d4m10n has already ceded that point.

Happy to concede that you were talking about a condition which has nothing to do with the subject of this thread, and that I missed it the first time around. (My bad, to be sure.)

Interested to see if you ever get around to addressing any of problems discussed respecting puberty blockers used on early adolescents as a first step in gender affirming care, though.

 

[Ziggurat]

I guess we are in that world, since Ziggurat thinks "actually, puberty blockers aren't technically completely reversible" is an intelligent response to the claim that puberty blockers are reversible.

Find me a single study that demonstrates that puberty blockers used to treat gender dysphoria are reversible.

 

[mumblethrax]

For example:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243894
"Height and weight were normal at baseline. Height growth continued through the study but more slowly than expected for age"

This is not surprising, as suppressing puberty suppresses pubertal growth. But this is not evidence of stunted growth, since children will eventually go off puberty blockers and continue to grow. In fact, children who take puberty blockers are slightly taller than usual due to delayed plate closure.

No mention of cognitive impairment, no mention of inability to orgasm. It's basically just bone density. Even the infertility thing is only mentioned when combined with "gender affirming" (ie, sex denying) hormone treatment. So yeah, they talk a bit about some of the negative side effects. But they're still very much underselling how big the risk is, and how potentially bad the side effects are.

Well there's no mention of "inability to orgasm" because there's no evidence of "inability to orgasm". I rather think you're overselling the risks.

And you've badly misidentified what "reversible" even means, and the fact that there is no proof or even good evidence that they are reversible when used to treat gender dysphoria.

I have a pretty good handle on what reversible means. But of course there's proof. Go off puberty blockers, and puberty resumes. This, again, is the relevant sense in which puberty blockers are "reversible".

If you stay on these drugs long enough (and many patients do), you never go through puberty at all. Even by your own definition, that's not reversible.

In particular, I have a good handle on what -ible means. You don't seem to.

 

[mumblethrax]

Interested to see if you ever get around to addressing any of problems discussed respecting puberty blockers used on early adolescents as a first step in gender affirming care, though.

Interested to see if anyone else ever gets around to discussing any of the benefits.

 

[Ziggurat]

I have a pretty good handle on what reversible means. But of course there's proof. Go off puberty blockers, and puberty resumes.

You say this, but where's the evidence that it actually happens for children being treated for gender dysphoria? There is none. The proof you claim doesn't exist. There is no clinical data to back up your claim that normal puberty resumes. Not a single study demonstrates this.

 

[Ziggurat]

Interested to see if anyone else ever gets around to discussing any of the benefits.

I've discussed the benefits. And they consist of producing cosmetic results more in line with the opposite sex than patients who wait until after puberty to do any sort of medical transition.

That's not worth the price.

 

[Emily's Cat]

No, that's not an off-label usage. They are approved by the FDA for use as puberty blockers.

No. They're approved as treatment for precocious puberty. Their use for gender dysphoria is off-label.

Why do you keep conflating precocious puberty with transgender stuff?

 

[Olmstead]

Interested to see if anyone else ever gets around to discussing any of the benefits.

The idea is that it would make people with gender dysphoria happier and less likely to commit suicide. The actual data is somewhat controversial:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169497/

 

[Elaedith]

Interested to see if anyone else ever gets around to discussing any of the benefits.

Benefits are very difficult to evaluate for multiple reasons. One is that people claim different types of rationale for use, as described in the Cass review I linked to before.

Most studies focus only on short-term benefits to mental health. However, they rarely compare to alternative approaches such as psychotherapy, and those that do don't use any method of random assignment or even proper matching of controls. Often the comparison group is either a waitlist control receiving no treatment at all, or a group that was rejected for puberty blockade due to other mental health diagnoses, who would on average be expected to have worse mental health to start with.

Even then, outcomes are frequently misrepresented (I will try to post a few examples when I get time).

If blockers do prevent the natural resolution of gender dysphoria, then the fact that some are happy with their transition and convinced it helped them cannot meaningfully be classed as a benefit without knowing whether they would have been equally happy after going through natural puberty. To answer this would require a study using random assignment to blockers or a control group going though natural puberty (with an alternative non-medical theraputic approach), after being assessed as suitable for puberty blockers. There is no such study.

Lack of evidence perhaps explains why organisations such as the AAP had to misrepresent the evidence to produce a policy document supporting the affirmation-only approach, as we discussed here before.

 

[theprestige]

Interested to see if anyone else ever gets around to discussing any of the benefits.

The trans-activists are welcome to do that any time. Tell us why puberty blockers are so great. Tell us about how the benefits outweigh the costs. Tell us what medical diagnoses indicate a prescription of puberty blockers as the least harmful treatment.

Make the argument for puberty blockers as a treatment for gender dysphoria in prepubescent children. Go ahead.

The argument against is already well-made:

- The long-term effects are deleterious.

- The long-term effects are not reversible.

- Gender dysphoria in prepubescent children is often best treated by just letting them go through normal puberty.

So. What's the argument for it?

 

[mumblethrax]

No. They're approved as treatment for precocious puberty. Their use for gender dysphoria is off-label.

Incredibly dishonest. Here's the chain of that conversation for you again:

FYI, that's actually NOT what the drugs say on the tin. Their approved usage is as treatment for cancer. They are used off-label to block puberty.

No, that's not an off-label usage. They are approved by the FDA for use as puberty blockers.

As you can see, you claimed that their use as puberty blockers was off-label, and that they were approved only for use in treating cancer. I claimed that they were approved as puberty blockers (and not for "their use for gender dysphoria").

Why do you keep conflating precocious puberty with transgender stuff?

I haven't done that at all. You don't seem to be able to keep the conversation straight.

 

[mumblethrax]

The trans-activists are welcome to do that any time.

I suppose I'll wait for them to show up, then.

 

[Louden Wilde]

For example:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243894
"Height and weight were normal at baseline. Height growth continued through the study but more slowly than expected for age"



No mention of cognitive impairment, no mention of inability to orgasm. It's basically just bone density. Even the infertility thing is only mentioned when combined with "gender affirming" (ie, sex denying) hormone treatment. So yeah, they talk a bit about some of the negative side effects. But they're still very much underselling how big the risk is, and how potentially bad the side effects are.
And you've badly misidentified what "reversible" even means, and the fact that there is no proof or even good evidence that they are reversible when used to treat gender dysphoria.

If you stay on these drugs long enough (and many patients do), you never go through puberty at all. Even by your own definition, that's not reversible.

Indeed (re: the highlighted). The pdf that mumblethrax linked to also noted that the drugs have been used as puberty blockers for ~30 years. This sounds like a long time, but that means the kids it was used on are only in their mid 40s. You'd like a broad health assessment of those initial cohorts, at the very least.

As an analogy, I used to point that (when teaching advanced classes) that we still don't whether people conceived IVF will have normal lifespans (the first being born in 1978), but we know they often exhibit epigenetic alterations

 

[theprestige]

I suppose I'll wait for them to show up, then.

Seems like the null hypothesis and the Hippocratic Oath prevail, then: No puberty blockers for prepubescent children suspected of having gender dysphoria.