Monday, November 4, 2019

Christian Post asks the right question - Accepts the wrong answer

Saturday, according to Brandon Showalter at Christian Post: Puberty blockers yield 'the most insidious child sterilization programs ever devised,' doctors say. The post is nonsensical BS and the “doctors” are Defenders of the Faith™ who are trying to conform medical science to scripture.

Sunday, I posted a statement from the Pediatric Endocrine Society which is trying to combat some of the sophistry associating with the gender-affirming care model.

One of those sophists is Dr. Michael K. Laidlaw. Laidlaw practices endocrinology in Rocklin, CA but he is not board certified. Laidlaw has also created seemingly independent websites to dishonestly echo his anti-trans nonsense. One of those is the Kelsey Coalition.

Returning to the Christian Post:
Michael K. Laidlaw
Warrior for the faith, Dr. Michael K. Laidlaw of Rocklin, CA is at odds with his own professional organization, the Endocrine Society.
via YouTube
[The statement from the Pediatric Endocrine Society is] is patently false, said Michael Laidlaw, an endocrinologist based in Rocklin, California, in a Wednesday interview with The Christian Post. "What these medical societies have created is an institutionalized childhood pathway toward sterility."

When asked by CP if he could explain why organizations that are ostensibly out to help children would recommend treatments that disrupt the normal process of puberty, he said it's critical to understand that, with respect to this topic, medical organizations like the Endocrine Society, Pediatric Endocrine Society, and the American Academy of Pediatrics have been taken over by the most radical elements of the profession.
Right. It's all a huge conspiracy orchestrated by radical LGBTQ activists who have taken control of the professional associations. Sure.

If those are “the most radical elements of the profession” then they are in the minority. If they have gained control of the professional organizations then that is with the consent of the majority. Laidlaw needs a better excuse for being at odds with his own professional organization, the Endocrine Society.

Additionally, that still doesn't answer the question that Showalter asked. Why would even “radical” doctors recommend interventions that are not in the best interests if children? We know why Laidlaw does what he does. It's all about conservative Christianity which means that it boils down to conflicts with ancients texts. More specifically, Laidlaw's problem rests with Genesis 1:27.
It is a nefarious conspiracy
"These radical trans activists were involved in writing the Endocrine Society guidelines in 2009 and 2017. These are low to no quality evidence guidelines, and anyone can read for themselves the poor evidence they have for these treatments for children and adolescents. There is no long-term evidence for benefits for these treatments. These drugs are not FDA approved for this condition. They have created a pathway toward sterility," Laidlaw stressed.
The above is misleading. Puberty blockers and cross-sex hormones are prescribed “off label.” According to the Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services: “This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.” These medications are FDA approved and have been tested for safety.

Undermining their own argument:
Laidlaw recounted a Dutch study of 70 children who were on puberty-blocking drugs, every one of which continued on to cross-sex hormones. Most of them went even further and underwent masculinizing or feminizing surgical procedures.

"All of those who started on blockers and went to cross sex hormones are infertile. Those who had gonads removed are sterilized," he said.
The reason (as I explain below) that these adolescents did not desist from puberty blockers is that only the most severe cases of gender dysphoria result in transitioning. Severe cases are the most persistent. Laidlaw's argument makes as much sense as telling people to die from cancer because chemotherapy causes nerve damage.

Defender of the Faith #2:
Dr. William Malone, an endocrinologist from Twin Falls, Idaho, emphasized that the statement regarding the treatment of gender dysphoric children and adolescents contravenes both scientific literature and common sense.

"No child is born in the wrong body, but for a variety of reasons some children and adolescents become convinced that they were," Malone said in a Wednesday interview with CP.

"Until very recently, these children and adolescents were supported and cared for with counseling. With counseling, or even watchful waiting, an average of 85% of these children would have resolution of their distress by early adulthood. There are currently 10 studies in the medical literature demonstrating this."
William J. Malone is a board certified internist practicing out of a small Catholic hospital in Idaho. He has a sub-specialty certification in endocrinology and treats diabetes and metabolic disorders. He has no experience with pediatric gender dysphoria. Malone is not a psychiatrist.

Malone is also being dishonest. It is true that a large percentage of children with gender dysphoria desist. However, those kids were never transgender in the first place.. Persistence of the condition is directly related to its severity. As a matter of simple logic, those who transition are those in the most distress and they are not going to desist. This is confirmed by research.

Dr. Kristina Olson at University of Washington is one of the nation's leading experts on gender diverse children and adolescents. The primary findings from her research are something that Dr. Malone should be paying attention to (if he is not too busy defending the stupidity the emanates from the Vatican on this issue):
We have two main findings so far. The first is that the gender development of socially transitioned trans kids seems to look a lot like that of cisgender kids [kids who are not transgender]. They show similar gender preferences and similar gender identities as their gender-matched peers and gender-typical siblings. These are kids that are saying, “I’m a girl,” and on all the traditional measures of gender development in the literature they look like the average cisgender girl (Child Development Perspectives, Vol. 12, No. 2, 2018).

Our second finding is that these kids, who are living as their gender identity in everyday life and supported by their families in that identity, seem to have pretty good mental health (Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 56, No. 2, 2017). They have slightly higher anxiety compared with cisgender kids but similar rates of depression—nowhere near the kind of clinical levels that we often see in prior studies of transgender teens and transgender adults.
Family support is a critical factor in the normal development of transgender children. Malone and Laidlaw are both contributing to a climate of ignorance and intolerance. They would have parents believe that they can prevent children from becoming transgender by withholding acceptance and that is simply and succinctly bullshit.

The same kids will become transgender (eventually) with, or without, acceptance and support. In the absence of family support might become neurotic, miserable and poorly functioning people. With support they can be as healthy and happy in life as their peers.

Dr. Olson also said:
Previous studies that look at transgender teens and adults have often found very high rates of anxiety, depression and suicidality. But the majority of people who are transgender adults today didn’t have the kinds of experiences that the kids I’m following did. Namely, they didn’t live as their identified gender early in their development. They didn’t necessarily have family support for their identity. It was a different time in history. What we’re trying to do now is to understand which of those differences might explain why these kids are doing so well. And we want to follow these kids to understand whether this good mental health we’re seeing at early ages continues as they move into adolescence.
So the key question for these doctors is a simple one: Is your priority pleasing Jesus or Moses or is it the best medical interests of children? To put it another way, do they want to practice medicine or theology?

Any religious concession to medical science renders that physician unqualified to treat any condition in any form at any time. Faith-based belief systems simply cannot be merged into evidence-based science.

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