Thank you for this well written, well argued piece. I applaud the courage of the author. Thank you to the Sensible Medicine team for posting it. I do believe medical professionals have good intentions in this field, but it is time to recognize that the US is becoming an outlier in its approach to caring for gender questioning youth…and n…
Thank you for this well written, well argued piece. I applaud the courage of the author. Thank you to the Sensible Medicine team for posting it. I do believe medical professionals have good intentions in this field, but it is time to recognize that the US is becoming an outlier in its approach to caring for gender questioning youth…and not in a good way. The UK, Sweden, France, Norway, Germany & others are all taking a step back, tapping the breaks & being more cautious in their approach to care for this group of patients. They have all realized that there are profound problems with the existing research. The Cass Review reveals this & calls for using medications only in research settings moving forward. In addition, recent court proceedings in Alabama have unearthed information which shows that WPATH commissioned Johns Hopkins to do systematic literature reviews for them in 2020, but then suppressed publication of all but one report when it became clear that the evidence contradicted WPATH’s current policies. This should alarm all of us.
WPATH is also the same agency who removed a chapter on ethics and listed recommendations which lack a grading system to indicate the quality of the evidence in their own updated “Standards of Care 8.”
When the evidence base dictates, changes in practice standards must be made, and we ought not let our own hubris stand in the way.
I have followed this issue more closely than most because I have never been able to shake the uncomfortable feeling that there are many parallels between the opioid epidemic (read or watch “Dopesick” to better understand the analogy) & the evolution of gender medicine for adolescents in the US in the last 7-10 years. In both instances there were good intentions —to help patients in distress—but both led to poor / sometimes catastrophic outcomes when evidence emerged that should have led to a change in course, but was ignored. We owe it to these children & their parents to be honest (especially in the realm of informed consent) & to provide better care. That starts with simple initial approaches like treating kids who are gender non-conforming with unconditional love (you are OK as you are), showing them that there is more to them as human beings than their gender identity, avoiding adherence to old gender stereotypes & doing a proper Biopsychosocial assessment. Sometimes less is more.
Thank you for this well written, well argued piece. I applaud the courage of the author. Thank you to the Sensible Medicine team for posting it. I do believe medical professionals have good intentions in this field, but it is time to recognize that the US is becoming an outlier in its approach to caring for gender questioning youth…and not in a good way. The UK, Sweden, France, Norway, Germany & others are all taking a step back, tapping the breaks & being more cautious in their approach to care for this group of patients. They have all realized that there are profound problems with the existing research. The Cass Review reveals this & calls for using medications only in research settings moving forward. In addition, recent court proceedings in Alabama have unearthed information which shows that WPATH commissioned Johns Hopkins to do systematic literature reviews for them in 2020, but then suppressed publication of all but one report when it became clear that the evidence contradicted WPATH’s current policies. This should alarm all of us.
WPATH is also the same agency who removed a chapter on ethics and listed recommendations which lack a grading system to indicate the quality of the evidence in their own updated “Standards of Care 8.”
When the evidence base dictates, changes in practice standards must be made, and we ought not let our own hubris stand in the way.
I have followed this issue more closely than most because I have never been able to shake the uncomfortable feeling that there are many parallels between the opioid epidemic (read or watch “Dopesick” to better understand the analogy) & the evolution of gender medicine for adolescents in the US in the last 7-10 years. In both instances there were good intentions —to help patients in distress—but both led to poor / sometimes catastrophic outcomes when evidence emerged that should have led to a change in course, but was ignored. We owe it to these children & their parents to be honest (especially in the realm of informed consent) & to provide better care. That starts with simple initial approaches like treating kids who are gender non-conforming with unconditional love (you are OK as you are), showing them that there is more to them as human beings than their gender identity, avoiding adherence to old gender stereotypes & doing a proper Biopsychosocial assessment. Sometimes less is more.