Wednesday, December 19, 2018

Midweek gender sophistry

I am reliably informed that Cathy Ruse is a smart and very nice woman. But she does work for a hate group (Family Research Council). Today she writes: Parents Beware of Puberty-Blocker Propaganda. “Propaganda” suggests that people are trying to convince others of something that is not true.

What we know about puberty blockers in the treatment of gender dysphoric children is that they give the kid and parents some time to sort things out and that they are fully reversible. This information comes not from LGBTQ activists but from the people who treat children with gender dysphoria.

All pharmaceutical interventions come with risks. Even something as benign as Aleve can cause ulcers. Personally, I cannot take OTC decongestants. While they make most people a bit drowsy, they have the exact opposite effect on me. At issue is a very simple question: Are practitioners giving parents a thorough understanding of the risks and possible side effects of puberty blockers?

I have personally queried some of these physicians and the answer is complex. Yes, they provide complete and accurate information. However, not all parents fully understand the information that they are being provided with. For them it comes down to personal trust. Many parents ask: “were this your child, what would you do?”

There are many ways for a doctor to make considerably more money with far less work. My take is that these are highly dedicated professionals whose only interest is the children they treat.

According to Ms. Ruse:
Transgender activists promote puberty blockers as safe, effective, and reversible. A new column at The Federalist details why medical experts disagree.

Originally used to treat prostrate [sic] cancer, puberty blockers are also used for endometriosis and “precocious puberty” (for girls under 8, boys under 9).

But using puberty blockers to stop normal puberty is “off label,” meaning no research has been done to prove the safety of such use and the FDA hasn’t approved the drug for this purpose.
Who are these nefarious “activists?” I'll get to the post in The Federalist shortly but first I need to correct an error of fact. “Off label” does not indicate an absence of research. It means that the FDA has not approved the drug for a specific purpose. Keep in mind that the FDA allows doctors to make a professional determination meaning that off label prescriptions are perfectly legitimate. Research has determined the overall safety and dangers of the med regardless of why it is prescribed.

I actually take Adderall off-label to help me tune out the hypervigilant noise caused by acute PTSD.

The Federalist:
On December 14, I made a deliberate decision not to write about Jane Robbins' post titled: Why Puberty Blockers Are A Clear Danger To Children’s Health. I should have but anti-trans-for-god-fatigue set in. Jane Robbins is a fellow with the American Principles Project. APP, founded by Robert P. George, has a considerable anti-LGBT advocacy record. Ms. Robbins is utterly obsessed with attempting to marginalize transgender people, presumably on behalf of the Catholic Church. She writes about nothing else in spite of a Harvard Law degree.

According to Robbins:
Citing guidelines issued by the political advocacy group World Professional Association for Transgender Health (WPATH), these physicians admit that the effects of cross-sex hormones are generally irreversible. Vulnerable patients who agree to this treatment are thus crossing the Rubicon into permanent bodily impairment.
That is untrue on two counts. WPATH is not a political advocacy group. Rather, it is a professional association working to establish the best care for transgender people. Also, their assessment is not what Robbins claims:
A special group of individuals are prepubertal or pubertal adolescents who will never develop reproductive function in their natal sex due to blockers or cross gender hormones. At this time there is no technique for preserving function from the gonads of these individuals.
That does not mean that all recipients of puberty blockers or hormones will never develop reproductive function. It is limited to “a special group.” If I could find percentages I would post them. I cannot but, to me, “special group” means a small minority. No one has ever claimed that puberty blockers and hormones are risk free.

Furthermore, the subtitle of Robbins' post reads:
As much as transgender ideologues disguised as doctors want to claim otherwise, some drugs pose serious and lasting risks to children.
Claiming that the doctors have a hidden agenda and then claiming that they warn of serious side effects to the treatment they generally recommend seems like a contradiction to me. The fact is that WPATH is extremely conservative. Some would say too conservative.

Doctors who treat transgender people (including children) are not overly concerned with the view from the Vatican by theologians and catechists. Ms. Robbins' only concern seems to be the opinions of Catholic prelates. The Vatican is promoting and propagandizing the marginalization of both transgender people and their medical providers. People like Robbins see LGBTQ activists everywhere. What the hell is she if not an activist on behalf of religious dogma. At times it seems indistinguishable from ISIS or Iran's high mullahs.

If there is a danger it is medically treating people according to faith-based religious beliefs rather than evidence-based medical science.

Robbins indulges in about 1,500 words to warn of the dangers of Lupron (actually the puberty blocker is Lupron Depot which is a different formulation). Puberty blockers come with some risks and doctors fully inform parents and children of those risks. When prescribed, it is their view that the benefits outweigh the risks. None of these providers are mad scientists or crackpots. They rely on the best information available today.

Then we arrive at:
Outgrowing Dysphoria Naturally

If this weren’t enough reason for parents to refuse such treatment for their minor children, Laidlaw says that “what parents should find truly terrifying is the psychological effect of this medication.” Under the traditional treatment for gender dysphoria, which involves “watchful waiting or pursuit of family and individual psychotherapy,” between 80 and 95 percent of adolescent patients outgrow their dysphoria naturally.

In other words, only 5 to 10 percent of those children remain dysphoric and go on to request further treatments. But a major study of dysphoric children who were administered puberty blockers found that 100 percent went on to request cross-sex hormones.
First of all the science differentiates between children and adolescents. Adolescents (teens) almost never desist. Robbins goes on to claim that the puberty blockers cause the kids to remain gender dysphoric.

The real answer is that the administration of puberty blockers is dependent upon the severity of the condition. When gender dysphoria is of sufficient severity that it compels the child to transition, he or she might receive the medications. So desistance relates to severity not the pharmaceuticals. Robbins is deliberately confusing correlation and causation. Many of “them” do which is part of the causation of my fatigue.

By the way, the Laidlaw she refers to is Dr. Michael K. Laidaw. Laidlaw, an endocrinologist, is at odds with his own professional organization. Laidlaw is a Catholic warrior who signed the letter from a hate group to the Trump administration.

Robbins goes on to rely on the phony professional organization and hate group, American College of Pediatricians. You must forgive me for not going there. Eventually she concludes:
Rosenthal, Dr. Johanna Olson-Kennedy, and the other medical ideologues who plow ahead with these therapies haven’t refuted these concerns. They seem to simply ignore them. That such behavior is allowed by the medical establishment, and even funded by federal tax dollars, is a travesty. Can we sink any lower than to sacrifice children to political ideology?
Rosenthal is Dr. Stephen Rosenthal, a pediatric endocrinologist and co-founder of the UCSF Child and Adolescent Gender Center. Dr. Johanna Olson-Kennedy is a trans youth specialist at Children's Hospital Los Angeles. She is on the faculty of USC's Keck School of Medicine. Don't you just love a religious zealot calling erudite medical practitioners “ideologues?” There is nothing to refute or, for that matter, to ignore. The issues are very simple: Are parents and children adequately informed? Are risks and benefits weighed properly?

There is no cure for gender dysphoria and it has the very real potential to cause self-harm. Research continues to demonstrate that the risks are significantly diminished when children are permitted to transition. Who to believe? The religious warriors and their hate group or the doctors who actually treat these at-risk children?

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