Tuesday, March 10, 2020

Breitbart and ACPeds - What Could Possibly Go Wrong?

Medical issues require medical treatment.
According to medical science the use of puberty blockers is safe, effective and fully reversible. According to research published in February to Pediatrics, the journal of the American Academy of Pediatrics (emphasis added):
There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.
Obviously this article was subjected to rigorous peer-review which is the practice of this particular journal.

It stands to reason that quality of life for a transgender adult is directly related, at least in part, to the extent that their presentation matches their gender. The ability to “pass” is enhanced when the development of secondary sex characteristics associated with the individual's natal sex was inhibited at puberty.
Enter Breitbart's expert
Dr. Susan Berry, we are told, is a psychologist who has a transgender fetish of some sort. Breitbart provides no details regarding where this individual is located or from where she received her PhD. Were it from Harvard, we would know.

Suffice it to say that a psychologist who doesn't accept the existence of transgender youth knows very little about a medication administered by pediatric endocrinologists.

Berry's headline reads: Pediatricians: Study Approving Puberty Blockers for Adolescents Is Flawed. The statement by said pediatricians is a comment to the research linked to and cited above. Comments are obviously not peer reviewed. They are emails. Both pediatricians, Scott Field and Den Trumbull are based in Alabama and both are associated with the American College of Pediatricians (ACPeds)
ACPeds is, according to the Southern Poverty Law Center, an anti-LGBTQ hate group. 2018 revenues were all of $137,000. Revenues of the real professional organization, the American Academy of Pediatrics, were $121,420,500.

The closest that these men come to being researchers or academics is Dr. Scott S. Field who is adjunct faculty at University of Alabama School of Medicine. According to these two geniuses:
Given the controversy surrounding the practice of puberty suppression for gender dysphoric adolescents, the article by Turban et al.1 creates more confusion than clarity.
Given the fact that puberty suppression is recommended by the American Academy of Pediatrics, the Endocrine Society and the Pediatric Endocrine Society, what controversy exists? It exists for some people on religious grounds.
The authors imply causal evidence for a reduction in suicidal ideation with transgender adolescents who received puberty suppression (PS), yet they fail to acknowledge the exceedingly high rates in both groups of suicide ideation (75% and 90%) and suicide attempts (42% and 51%).
Wrong. The results of the study are a significant reduction in suicidal ideation with transgender adults who received puberty suppression as adolescents. I have no idea what constitutes “both groups.” Adults who did and did not receive puberty blockers as adolescents?

They do not identify the source of their suicide numbers. Those would not rebut the metrics of the study which demonstrate a significant decrease in suicidal ideation and suicidality among trans adults who received puberty blockers as adolescents.

I trust Dr. Jack Turban's math over two defenders of the faith associated with ACPeds.

The open question that I have for Jack Turban I will not pose because the answer cannot be known: Do they have lower rates of suicide attempts/ideation because they took puberty blockers or because they had supportive parents who allowed them to take puberty blockers? That support would probably follow into adulthood.

Getting back to Breitbart's Susan Berry, the subheading reads:
Two pediatricians say data from a study published at the official journal of the American Academy of Pediatrics (AAP) actually reveals the opposite of what its authors conclude – that puberty blockers are linked to positive mental health outcomes in youth claiming to be transgender.
That is not what they are saying. Not at all. If they are then they fail to provide sufficient explanation and detail to support that contention. Most of their comment asserts that the subjects of the study were too young for the investigators to claim a lifetime reduction is suicidality.

If Drs. Scott Field and Den Trumbull have something important to say then they should do the research. They should then publish the results to a respected and peer-reviewed academic journal.

According to them they have already completed the necessary research. They could publish with the data that they now claim to possess if the data is reliable. What is stopping them from doing so?

I will take this opportunity to make clear that American College of Pediatricians is devoted to misinforming parents about gender-diverse youth. According to a November, 2018 “position statement,” pretentiously and misleadingly styled as research:
A review of the current literature suggests that [the gender-affirming] protocol is founded upon an unscientific gender ideology, lacks an evidence base, and violates the long-standing ethical principle of “First do no harm.”
Doctors referring to clinical practice standards as an “ideology” do not inspire confidence. If their statement (masquerading as research) would survive peer review then they might succeed in having it published to a respected academic journal. It will not survive peer review and it has not been published.

Unscientific describes efforts to conform medical science to Christian dogma. Ideology describes that dogma, not science based upon peer-reviewed research conducted by highly qualified investigators.

Another document is titled Guidance for parents of children with gender identity distress. This begins with “Advice to parents from a therapist critical of gender ideology.” That “therapist” is not identified. Is he or she a board-certified psychiatrist? Referring to gender dysphoria as “gender identity distress” or “gender ideology” is not a good start.

From there:
Visit this valuable online parent community: Visit this valuable online parent community: www.kelseycoalition.org/

A second online support group for parents with children who seemed to display Rapid-Onset Gender Dysphoria (ROGD): www.parentsofrogdkids.com/
The first of these sites is anonymous with anonymous contributions. I have speculated that it is the handiwork of the insane Dr. Michael K. Laidlaw, an endocrinologist who is not board certified.

The second site presupposes that a condition exists for which there is no evidence of existence (Rapid Onset Gender Dysphoria). It is another anonymous site.

From there they specifically steer people away from qualified practitioners:
Avoid "Gender therapists," “Gender-Affirming” therapists, “LGBT Affirming” therapists, “LGBT Affirming” therapists, “LGBT-Affirming” therapists, and Affirming” therapists, and "Gender clinics."

These are all titles of therapists who seek to validate and affirm your child’s gender disturbance as normal. Consider searching for experts in body image & eating disorders, self-harm, trauma, anxiety disorders, women’s issues, sexual abuse & domestic violence. You know your teen best. If your child has struggled with depression their whole life, seek an expert in teen depression. If he or she has obsessive-compulsive tendencies, seek out an OCD expert.
Eating disorders? OCD? Gender incongruence is not a disorder according the the American Psychiatric Association and it has nothing in common with eating disorders or OCD.

What a parent first requires is a board certified psychiatrist, preferably with a subspecialty in pediatrics. You can check board certification here.

The result will also tell you whether or not the physician is a participant in MOC (maintenance of certification). Up until 1988 (slight variances in professional organizations) doctors were issued permanent certifications. Since 1988 doctors have been required to maintain their certification through continuing education.

Many doctors with permanent certificates also participate voluntarily in MOC. Doctors who continue their education throughout their practice are the most up-to-date and the best informed. They are also the most professional clinicians.

If a child has gender dysphoria they need to be diagnosed along with an opinion as to its severity. ACPeds doesn't want kids properly diagnosed because they have a religious objection to the existence of transgender people. The best source of an accurate diagnosis comes from a psychiatrist with experience in this area.
Therapy should seek to uncover what psychological purpose the “trans” identity serves; what possible events and/or relationships may be contributing to it. Sometimes parents' well-intended behaviors may have contributed to the gender dysphoria. Barring rare cases of objective abuse, therapists should not "take sides." Good therapists will help parents and children better understand themselves and each other, improving family communication and family connectedness in the process.
The above is the mythological “underlying cause” BS. Find the reason that someone has gender dysphoria, the “thinking” goes, and you can then know how to cure it. Research does not support that approach.

Parents need to accept the fact that acute distress has the potential to be lethal. Esoteric approaches to satisfy Christians are counterintuitive.

On three separate occasions I have appeared at the emergency room with a kidney stone. In terms of pain, getting shot was a minor irritation compared to the pain caused by a kidney stone.

Not once did people in the ER attempt to determine the cause of the kidney stone. They confirmed its presence and treated me with morphine injections. They connected me to intravenous which loaded me up with fluids, Gender diverse kids are in pain too. It is just as severe and it is far more lethal.
Interview your potential therapists. Ask them if they believe trans identities are innate, fixed, and treatable only with medical or chemical intervention. If they do, avoid them. Ask them directly about how they help children in your child's situation.
Coming from a supposedly professional group, this is the most idiotic form of questioning. This has nothing to do with “trans identities.” The issue is pediatric gender dysphoria. Treatment options are based upon the severity of the condition and the likelihood of persistence (which is usually a function of severity).

Any therapist who would claim never to treat a child with medical interventions is a religious crackpot per se. Run. For that matter if said physician uses FAC in his website, Run! That is shorthand for Fellow of the American College of Pediatricians.

In pediatricians, you want to see FAAP (Fellow of the American Academy of Pediatrics). Psychiatrists: FAPA (Fellow of the American Psychiatric Association).

ACPeds goes on to recommend finding a therapist through the Christian Counselor Directory or CatholicTherapist.com. That is just plain stupid. Medical science is a secular pursuit. Evidence-based science is compromised when attempts are made to modify it with faith-based religious beliefs.

Parents need to be smart. No one volunteers to have a transgender kid. However, that distaste should not create denial. Pretending otherwise will not make the condition go away.

Accepting the reality of gender is not going to lock in the condition. However, it will have an effect on the child's psyche. It should have an effect on the professional care that the kid receives.

We owe that to minors. No?

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