Tuesday, January 21, 2020

The SAME Doctor Pushing the SAME Bullshit

“There is a difference between offering an opinion and promoting an agenda…”
Michael K. Laidlaw
The very creepy Dr. Laidlaw
via YouTube
It comes as no surprise that Dr. Michael K. Laidlaw has authored: Transgender propaganda hides scary truth about puberty-blockers.
Do we know with certainty that all of the effects of the medications for stopping normal puberty are fully reversible? The answer is no.
“Certainty” and medical science are not good partners. For example, Prozac has been around for over 30 years. No one knows to a certainty that its benefits to any individual patient will outweigh the side effects, some of which are quite serious. In fact, no one knows to a certainty how Prozac works. Or how about man's best friend — Viagra? In its first 13 months of use, 522 deaths were reported due to using Viagra. No one knows to a certainty that a boner might not kill them.

Dr. Laidlaw wants people to believe that the opposite of certainty is experimental. That is simply not true.

Perhaps if Michael K. Laidlaw met maintenance of certification requirements he would still be a board-certified endocrinologist. Apparently, he did not which is why Laidlaw is not board-certified. Perhaps, if Laidlaw had met those requirements, he would not be so obtuse.

Aside from the lack of training Laidlaw lacks experience. It is hard to imagine that he has any transgender patients because Dr. Laidlaw is a Defender of the Faith rather than a defender of evidence-based medical science.
Abracadabra let's “experiment”
Is there anything natural about stopping normal puberty? Would you stunt a child’s normal eye development to make tiny eyes in an enlarging head? Would you stop a child’s limb development so that the torso lengthens, but arms and legs remain stunted? This sounds bizarre, because it is. But it is analogous in many ways to the ongoing experiment in stopping normal puberty.
Is there anything natural about favoring faith-based religious dogma over evidence-based science? Laidlaw's rhetorical question doesn't work because it defies common sense. What is — or is not — natural is not a consideration.
  1. Children with acute gender dysphoria are at significant risk for self-harm.
  2. Research demonstrates that the risk of self-harm is substantially reduced with gender-affirming care.
Therefore, the question has nothing to do with what is natural. Chemotherapy, for example, is unnatural. It involves the intentional administration of poisonous substances. The question becomes: Do the benefits provided by puberty blockers outweigh concerns? Patients and their parents need to answer that question after a thorough explanation of benefits and concerns by the physician or physicians. A doctor is free to offer a considered opinion.

There is a difference between offering an opinion and promoting an agenda, which is what Laidlaw is doing. Laidlaw's promotion requires him to withhold important information. Doing so is unprofessional and unethical.
A recent high-profile custody case in Texas — in which a mom is advocating the transitioning of her seven-year-old son James into a girl named Luna, against the wishes of his father — has brought the issue of child transition and puberty blockers to the attention of everyday Americans, elected officials, and people around the world. What has gone less noticed is the backing of the medical establishment. Professional societies are now promoting these untested treatments as solid, evidence-based science.
Mom happens to be a board-certified pediatrician and an academic. She is advocating for her child to be able to explore her sexuality. The only reason that this brought attention to puberty blockers was the dishonest rhetoric of religious warriors like Michael K. Laidlaw. The child is seven. Laidlaw knows perfectly well that puberty blockers will not be a consideration for another five or six years.

Indeed, Laidlaw is personally responsible for the Pediatric Endocrine Society deeming it necessary to offer up some truth via an official statement:
This concerns a 7-year-old transgender girl in Texas whose mother (a pediatrician) is supportive of her gender identity but whose father is not. The parents are involved in a custody battle that has drawn significant media attention. The father has reached out to conservative groups and lawmakers who are spreading misinformation about care of gender variant youth and are threatening to introduce legislation prohibiting the use of puberty blockers in transgender patients. Our statement affirms the PES supported Endocrine Society guidelines as well as the AAP guidelines regarding management of transgender youth.
October 28, 2019

Pediatric Endocrine Society Statement Against Public Discourse that Risks the Well-being of Transgender and Gender Diverse Youth and their Families
Through this statement, we express our concern for the health risks and safety of transgender and gender diverse youth and their families, when public discourse delegitimizes their right to express their gender and to receive gender-affirming care. This is not only harmful to the mental and physical health of these youth, but opposes current standard of care recommendations.
Puberty suppression once puberty has started. This is a reversible treatment that decreases the distress of having the “wrong” puberty. This treatment alone does not cause infertility.
Laidlaw is fighting desperately to preserve the notion that puberty blockers are not reversible.
Approximately two weeks after James’s plight garnered international attention in late October, the Pediatric Endocrine Society (PES) issued a statement regarding medical therapy for children who are uncomfortable with their sexed bodies. In that document, the organization states that the effects of puberty-blocking medications are reversible. Other organizations such as the American Medical Association are leading kids toward these harmful drugs by supporting bans on therapies that aid children in becoming comfortable in their natural bodies.
Laidlaw provides a link for therapies that aid children in becoming comfortable… No, he is not linking to research. He is linking to this:
Click on image to enlarge
Furthermore, Laidlaw is positing that the lack of certainty means that puberty blockers are harmful. Again, Michael K. Laidlaw is withholding important information. What are the benefits and what are the concerns. Laidlaw will not risk empowering anyone to be a critical thinker. Then it's back to certainty vs. experimentation again:
But do we know with certainty that all of the effects of the medications for stopping normal puberty are fully reversible? Has the FDA determined that there is scientific evidence to validate this claim? Have there been any rigorous long-term studies addressing this question? Is social transition truly harmless? Is it ethical to continue this experiment on children?
Laidlaw's intellectually dishonesty is staggering. He is substituting rhetorical questions for the information that a normal individual requires to reach a rational conclusion.
Laidlaw attempts to describe an “urgent public health problem”
…although the studies on this are limited, the data we do have indicate that the overwhelming majority of adolescents on puberty blockers decide not to reverse course, but instead move on to cross-sex hormones and then to sterilizing genital surgeries. This is in marked contrast to the experience of children who experience gender dysphoria but are allowed to go through puberty normally, the vast majority of whom do not persist in identifying with the opposite sex.
Laidlaw is making two dishonest claims:
  1. Providing puberty blockers means that a child will progress onto more radical forms of affirmation and;
  2. Not providing puberty blockers means that the child will outgrow the condition.
The first of those claims is a half-truth and is based on a recent Dutch study. It is intended to scare the crap out of parents. The truth is that the persistence of gender dysphoria directly correlates to the severity of the condition. Only the most acute cases transition. Therefore, it is expected that they will go on, in later teens, to cross-sex hormones. Gender confirmation surgery is an option in adulthood.

The children who do not use puberty blockers are those who are less severely affected and unlikely to transition. Since persistence is a function of severity it is expected that those children will naturally desist.

Laidlaw is dishonestly suggesting that denying puberty blockers to children in severe distress will cause them to desist. Laidlaw offers no evidence to support a counter-intuitive proposition.

After cataloging the many possible side effects which no one denies:
So Much for a “Pause Button”

Proponents of puberty blockers present them as a simple “pause button,” whereby puberty can be stopped and restarted at the whim of physicians. But is this really the case?

In the absence of puberty blockers, signaling from the hypothalamus occurs at a preprogrammed time, triggering the start of normal puberty. We do not know if there is an endpoint to the window of time in which puberty can take place. In other words, if one stops normal puberty at age ten and then allows it to begin again at age fifteen, we do not know if the signaling mechanism will return fully. There is evidence to suggest that it will not.
Laidlaw has no clue how puberty blockers are explained to children and their parents. Remember that he was arguing that puberty blockers will never be stopped until they are replaced with cross-sex hormones. Now he is claiming that they might be stopped and might not be reversible. The question is — and always will be: Do the benefits outweigh the concerns? Laidlaw refuses to concede that there are very real benefits. His presentation relies on being one-sided.

Laidlaw is not interested in informed consent. He wants to talk parents out of using puberty blockers and he is doing so because of religious beliefs. The scare campaign includes this tidbit:
It Begins with Social Transition

What exactly is known about the limited number of adolescents who have undergone this experimental therapy? How many kids actually decide to stop these medications and “unpause” puberty?
“Experimental” leads him back to the inexorable pathway that he discussed earlier. Laidlaw's thought processes seem very disorganized:
Very few, it seems. In a Dutch study that included seventy adolescents who went on puberty blockers, all seventy decided to go on to further medicalizing by using hormones of the opposite sex. In a follow-up study, the majority went on to have “sex reassignment surgery” by either vaginoplasty for males or hysterectomy with ovariectomy for females — sterilizing them. One patient even tragically died of necrotizing fasciitis — otherwise known as the flesh-eating bacteria — due to the surgery.
There are risks with surgery. The issue is not the risks but whether or not those risks are understood by the patients and how the risks are contrasted with benefits. Laidlaw is claiming anew that social transition leads to surgery which means that all of the rhetoric about the reversibility of puberty blockers was gratuitous after all.

Laidlaw wants people to believe that adults actively transition children:
Social transitioning a child involves parents, therapists, teachers, and other persons in authority reinforcing the gender non-conforming child’s false belief that he or she is of the opposite sex “inside.” The mind manipulation involves compulsory use of opposite-sex pronouns, and employing rigid sex-based stereotypes in clothing.
It's a conspiracy! These are all decisions that the kid makes. Laidlaw refers to gender nonconforming children incorrectly. A gender nonconforming boy, for example, likes girlie things but he is still a boy and is not gender incongruent.
Kenneth Zucker, an international expert in the field of childhood gender identity disorder, calls this intervention iatrogenic — an illness caused by a physician. He notes that “it should come as no surprise that the rate of gender dysphoria persistence will be much higher as these children are followed into their adolescence and young adulthood.”
I cannot find that quote in context. I believe that Zucker wrote that about two years ago. That could mean many different things. I prefer not to speculate. Then it's back to experimentation. This guy should stick with a concept, exhaust it and then move on to the next concept.
There is nothing healthy about stopping normal puberty, because puberty is not a disease. The practice represents an unethical medical experiment with both known and unknown harms to adolescent development and to the human person, during a crucial time in a young person’s life.
Then it's back to “they'll grow out of it if not treated:”
Children and adolescents suffering from confusion about their sexed bodies require compassionate care. We know that the vast majority of diagnosed children have been shown to desist or grow out of this condition if parents simply wait, rather than rushing to intervene.
It's bullshit because what he is saying is that not treating the condition is why they grow out of it. The truth is that the condition is not treated because it is not severe. The lack of severity is why children outgrow the condition.

Eventually, this thing comes to a conclusion:
I would challenge the Pediatric Endocrine Society to take the time to investigate the full scope of known and potential harms for using puberty-blocking agents to stop normal puberty. In the meantime, there should be a moratorium on their use for this purpose. Not to do so is a dereliction of duty of the highest order. It is an abandonment of the fundamental principle to First Do No Harm.
I would think that the PES has done just that. Who does Laidlaw think he is fooling? Laidlaw proposes this moratorium — not out of medical concern — but out of religious duty. “Dr. Dipshit” gives me a headache.

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