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Cont: Transwomen are not women - part XI

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Robin said:
If it were me I would want to know the details.

What steps did Bristow take to address this very serious matter?

Who did he inform and what was their response?

If the response was unsatisfactory, to whom did he escalate the matter?

Where did he document it?

These are all steps which a medical professional would take when notified of malpractice.
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All of these issues have already been discussed, including evidence from David Bell. The Bell report is mentioned in Barnes' book and Bell has discussed how he was treated when he questioned the affirmative policy. We previously covered the way whistleblowers were treated. Sonia Appleby won damages for vilification after raising concerns over the way children were being treated.
 
I would assume the Cass Interim report and Barnes' book will covet all that is in .the Bell Report in any case.
 
Elaedith said:
It was leaked to the press as described in this article.

I'm not aware of the full report being publicly available. There are varous discussions of the report contents from journalists who saw it, and David Bell has given various interviews about the issues.
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It's not necessarily going to give an indication of what he said at the time that isn't coloured by things that have happened since.
 
As an example of what I am talking about, Barnes details when and to whom Dr Hutchinson notifies her concerns and the noted she took of this at the time.

So if this government department had rampant homophobia I would expect to see this similarly notified, documented and escalated as per the established procedures.

If there were any evidence of anyone knowingly doing any malpractice or there was evidence of parents pressuring for transition then I would expect those who observed this to have notified, documented and if necessary escalated.

Barnes is careful to detail this in the case of Dr Hutchinson but not as I recall, do this in the cases of the allegations of pushing gay children towards transition alleged by Bristow and Spiliadis. I am rereading to confirm.

As I said, surveys show that there is much more social acceptance for lesbians, gay men and bisexuals than there is for trans people so if these parents came from areas of high homophobia then almost certainly they would come from areas of even higher transphobia, hence the unlikelihood that a parent who didn't want a gay child would want a trans child.
 
Robin said:
As an example of what I am talking about, Barnes details when and to whom Dr Hutchinson notifies her concerns and the noted she took of this at the time.

So if this government department had rampant homophobia I would expect to see this similarly notified, documented and escalated as per the established procedures.

If there were any evidence of anyone knowingly doing any malpractice or there was evidence of parents pressuring for transition then I would expect those who observed this to have notified, documented and if necessary escalated.

Barnes is careful to detail this in the case of Dr Hutchinson but not as I recall, do this in the cases of the allegations of pushing gay children towards transition alleged by Bristow and Spiliadis. I am rereading to confirm.

As I said, surveys show that there is much more social acceptance for lesbians, gay men and bisexuals than there is for trans people so if these parents came from areas of high homophobia then almost certainly they would come from areas of even higher transphobia, hence the unlikelihood that a parent who didn't want a gay child would want a trans child.
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Indeed.

On a more general note: I'm much more inclined to examine the (extremely-difficult-to-get-right*) issue of the Tavistock (and best practice approaches for minors presenting with transgender identity) by examining the actual official report, which had access to everyone and everything (good and bad).... rather than a book written by a journalist with an editorial slant and a propensity for listening to self-selecting interviewees with axes to grind.


* And it's important not to lose sight** of the fact that in many - maybe even most - instances of interventional treatment given to minors presenting with gender dysphoria, those treatments have led to positive therapeutic benefits and long-term successful outcomes. The incontrovertible fact that there's still a paucity of evidence from which to measure & compare outcomes, and thereby to tailor treatments to produce optimal outcome success.... a) doesn't in any way mean or imply that, in overall terms, the treatments given to minors over the past several years has been clinically improper, and b) means that clinicians will have no option but to use their clinical judgement (along with overall guidelines) to make decisions on treatments, up until sufficient evidence comes forth over time to add an evidence base to those clinical decisions.

** Though it's interesting to note how the recent "revelation" about the current (obvious) lack of a statistically-significant evidence base in this area has prompted certain commentators to claim that this factor, in and of itself, both 1) invalidates the treatments currently being offered in places such as the Tavistock, and 2) in some way imputes incompetent (and perhaps even malevolent) motives to the clinicians who've been making extremely difficult decisions with the aim of helping the patients under their care.
 
LondonJohn said:
Indeed.

On a more general note: I'm much more inclined to examine the (extremely-difficult-to-get-right*) issue of the Tavistock (and best practice approaches for minors presenting with transgender identity) by examining the actual official report, which had access to everyone and everything (good and bad).... rather than a book written by a journalist with an editorial slant and a propensity for listening to self-selecting interviewees with axes to grind.


* And it's important not to lose sight** of the fact that in many - maybe even most - instances of interventional treatment given to minors presenting with gender dysphoria, those treatments have led to positive therapeutic benefits and long-term successful outcomes. The incontrovertible fact that there's still a paucity of evidence from which to measure & compare outcomes, and thereby to tailor treatments to produce optimal outcome success.... a) doesn't in any way mean or imply that, in overall terms, the treatments given to minors over the past several years has been clinically improper, and b) means that clinicians will have no option but to use their clinical judgement (along with overall guidelines) to make decisions on treatments, up until sufficient evidence comes forth over time to add an evidence base to those clinical decisions.

** Though it's interesting to note how the recent "revelation" about the current (obvious) lack of a statistically-significant evidence base in this area has prompted certain commentators to claim that this factor, in and of itself, both 1) invalidates the treatments currently being offered in places such as the Tavistock, and 2) in some way imputes incompetent (and perhaps even malevolent) motives to the clinicians who've been making extremely difficult decisions with the aim of helping the patients under their care.
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Right.

So WHY WAS GIDS CLOSED?

There must be some grand conspiracy involved methinks….
 
I've only got through the first four episodes so far, but I'm finding The Witch Trials of J K Rowling to be a fairly even-handed look at the whole trans debate/TERF wars. Maybe I'm just too blind to see how biased it is, but that's how it looks to me.
 
The Tavistock centre will be closed with the roll out of a new service model which will address the issues identified the first stage of the Cass enquiry, ie

* The service is overstretched

* There is no way for any other mental health problems the patient's have to be treated once they start with GIDS.

This matches some of the issues Barnes outlines.

It has also recommended a rigorous data keeping protocol for the new centres.

The interim report doesn't mention it but the new model could help with the centralised power issues Barnes identifies.

For all the other things, we will have to wait for the completion of the enquiry.
 
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I would imagine, in keeping with precedents, Cass will deal with.any actual wrong doing in the final report.
 
LondonJohn said:
** Though it's interesting to note how the recent "revelation" about the current (obvious) lack of a statistically-significant evidence base in this area has prompted certain commentators to claim that this factor, in and of itself, both 1) invalidates the treatments currently being offered in places such as the Tavistock, and 2) in some way imputes incompetent (and perhaps even malevolent) motives to the clinicians who've been making extremely difficult decisions with the aim of helping the patients under their care.
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There may be cases where incompetence has occurred, I'm waiting for more information.

The Cass Interim report and Barnes' book emphasise the skill hard work and commitment to the well being of the patients exhibited by most of the staff.

Of course bad practice happens throughout medicine unfortunately. Our youngest suffered deafness for six months because our pediatrician wouldn't refer him to an ENT as we wished.and an audiology clinic tested normal hearing when he could not have had more than 5% of the sound penetrating.

The brother of a friend of mine at school nearly was disabled for life when his knee pain was diagnosed as psychosomatic.

There is a distinction between the problems at Tavistock, cause by organisational dysfunction and the general running down of the NHS and the status of treatment for.gender dysphoria generally.

That is, of course, the intended bait and switch intended by bringing up Tavistock in a discussion about the status of treatment for GD.

By the way, the Barnes book is actually quite good. From the comments I think that a few of those accusing me of not reading it have probably not read the whole thing themselves but just referred to parts reproduced in blogs here and there.
 
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Robin said:
There is a distinction between the problems at Tavistock, cause by organisational dysfunction and the general running down of the NHS and the status of treatment for.gender dysphoria generally.

That is, of course, the intended bait and switch intended by bringing up Tavistock in a discussion about the status of treatment for GD.
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In all the years this thread has been going, we've turned our attention to the NHS GIDS only when there was a new source of information about how they were practicing medicine.

If you'd rather talk about how (youth) gender medicine is done in, say, Canada, we're going to need different source materials, which may not yet exist.
 
d4m10n said:
https://pubmed.ncbi.nlm.nih.gov/36156703/
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Jesse Singal just unlocked a good critique of this study.

Maybe It’s A Bad Idea To Give A Bunch Of Kids Double Mastectomies Without Checking Whether It Helps Them

Among other things, the study didn't use any validated measures of mental health and used a non-validated scale of chest dysphoria which essentially just measures whether patients are unhappy about having breasts before surgery and less unhappy about having breasts once they no longer have them.
 
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LondonJohn said:
** Though it's interesting to note how the recent "revelation" about the current (obvious) lack of a statistically-significant evidence base in this area has prompted certain commentators to claim that this factor, in and of itself, both 1) invalidates the treatments currently being offered in places such as the Tavistock, and 2) in some way imputes incompetent (and perhaps even malevolent) motives to the clinicians who've been making extremely difficult decisions with the aim of helping the patients under their care.
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A key part of the Tavistock debacle was that they were NOT keeping sufficient evidence of those decisions and outcomes, as you well know.
 
LondonJohn said:
* And it's important not to lose sight** of the fact that in many - maybe even most - instances of interventional treatment given to minors presenting with gender dysphoria, those treatments have led to positive therapeutic benefits and long-term successful outcomes.
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No, there is no evidence of this. The methodologies used do not allow causal inference, not to mention lack of systematic long-term follow-up.
The incontrovertible fact that there's still a paucity of evidence from which to measure & compare outcomes, and thereby to tailor treatments to produce optimal outcome success.... a) doesn't in any way mean or imply that, in overall terms, the treatments given to minors over the past several years has been clinically improper, and
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Actually it does mean this. Giving irreversible invasive medical treatment with serious side effects and unknown risks, without sufficient evidence of benefits that exceed those of less risky treatments, is clinically improper.

b) means that clinicians will have no option but to use their clinical judgement (along with overall guidelines) to make decisions on treatments, up until sufficient evidence comes forth over time to add an evidence base to those clinical decisions.
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There is no evidence base 'coming forth over time' until there is properly-conducted systematic long-term research.

** Though it's interesting to note how the recent "revelation" about the current (obvious) lack of a statistically-significant evidence base
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The problem is not lack of a 'statistically-significant' evidence base, it is lack of properly-conducted research. Statistical significance does not establish validity.

in this area has prompted certain commentators to claim that this factor, in and of itself, both 1) invalidates the treatments currently being offered in places such as the Tavistock, and 2) in some way imputes incompetent (and perhaps even malevolent) motives to the clinicians who've been making extremely difficult decisions with the aim of helping the patients under their care.
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When clinicians and researchers repeatedly lie about evidence and try to silence critics, one makes inferences accordingly.
 
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