TrackerNeil

In my half-century on this planet, I have come to realize that any position, no matter how carefully or thoughtfully stated, can (and will) be opposed by some. I used to think differently, but...well, a half-century.

Great! So, given that both sides are politically motivated, perhaps we should all allow some humility into this conversation; after all, we can all be wrong, particuarly when our political beliefs are invoked.

So that would mean that those who oppose the Cass Review are also motivated by their political beliefs?

I usually try to assume that people actually believe what they say they believe, and not that they have political motives, but YMMV.

I accept that. I hope you can accept, in turn, that those who take the report seriously may be just as earnest, and may have approached the review with an equally open mind.

I think this really sums up the disagreement here; you either think the Cass Review is credible or you don't. Those who don't can accuse those who do of confirmation bias, and vice-versa, and around it goes. I don't know what else there is to say.

That's another curiosity, one that is so far unexplained, as far as I know. I'm not crying "social contagion", though; I'm saying that it's not unreasonable to wonder why the patient population has changed so notably in a relatively short period of time.

I suppose it doesn't, unless the folks in question are asking for medicalization, in which case I don't think it's unreasonable to wonder what might be happening.

That's one possibility, sure, but not the only one. For myself, if the number of people self-reporting as gay suddenly skyrocketed, I'd probably ask questions, too.

I'm sorry; I thought you meant a cooling-off period before taking PBs. I'll go back and edit that post accordingly, and leave this note here to document that I did so.

I'm not at all sure ths is the case in terms of receiving PBs, not at least from what I am reading. But that's not an issue related to the Cass report and I don't want to start thread drift. [CORRECTION: By "cooling off" I incorrectly assumed a period of time before taking PBs.] I'm not sure anyone really knows just how many detransitioners exist, because these data just aren't collected, most of the time. Detransitioners often report that, when they decide to stop taking PBs or hormones, they don't notify the clinic; they just never go back. The clinic, naturally, isn't going to count that person as a detransitioner. You can look at some of the studies on the topic and see a good rate of loss-to-follow up; I recall one in which 72 patients were studied, thirty of whom simply dropped out of the study. Maybe none of those people were detransitioners, maybe all of them were--we just don't know. These studies also often don't span much time; regret, when it happens, might not occur until 5-10 years after treatment, and we'd never know. And, really, that's the thrust of the Cass Review. Cass herself writes: That makes me uncomfortable. I think it should make everyone uncomfortable. In any case, I'm not here to argue about medical care for trans people in general; I'm interested in the Cass Review, which is available to all. I think folks have to read it and decide for themselves if this is something of concern.

I don't know that I am ignoring the most straightforward explanation; I'm saying I don't agree with yours. And I am in good company; the Cass Review states unequivocally: The report goes on: I think my concerns are in line with this report. Now, perhaps you think Hilary Cass picked her conclusion before she started and is trying to manufacture that conclusion, but I'd point out that she knows a heck of a lot more about what was going on at GIDS than you--and more than me, too. I imagine this report will be critiqued and evaluated, as it should be, but for now I feel pretty good that my concerns were shared by the expert who prepared this document.

The very reason the Cass Review was commissioned is that clinicians inside the GIDS center were saying that they did not know which kids needed PBs, and which didn't. They said that the clinic was handling too much demand, and that there was pressure to move these cases through. Jamie Reed said much the same about the clinic she worked for in Missouri. My understanding is that north of 95% of the patients given PBs by GIDS eventually went on to hormones. Now, it could be that the GIDS clinicians were doing an incredible job of determining who really needed them, although Hilary Cass herself doesn't seem to think so. It's equally possible--and Hannah Barnes has certainly suggested--that something about being on PBs makes it more likely a person will want to go on to hormones. We really don't know.

The suggestion Hannah Barnes makes is that PBs are justified on the assertion that they buy time to think, but if nearly everyone who takes them winds up making the same decision in the end, are they really thinking? Is there something about PBs that makes one more inclined to proceed to hormones? I don't know of a definitive answer to that question.

I think the question should not be "Whom do we believe?" but "How do we handle accusations?" Advocating for those we believe to be victims is fine, but when it comes to institutional responses, we have to make sure we're not replacing adjudication with advocacy. Specifically, I am thinking of college tribunals, which often run according to rules that bear little resemblance to due process. Respondents are often denied counsel, are not informed of the specific charges until the day of the hearing, are not permitted to cross-examine witnesses, and may not present refuting evidence. These sorts of hearings are clearly intended to produce claimant-friendly outcomes, which sounds good, but can have unintended consequences. Here's one of those consequences. Yale might have figured it was doing claimants a solid by tilting the playing field in their favor, but it didn't work out that way for this clamaint. So we have to keep in mind that what sounds good may not actually do good.