Do Extreme Interventions for Trans Youths Save Lives?

[icehorse]

What do you suggest? And how could this suggestion preclude taking puberty blockers?

A little context, this debate has been occurring across several threads here on RF, so it's understandable that some of the original context has been lost.

I've provided several links that show that many countries in Europe are rethinking the use of puberty blockers and surgeries on youths. There have been a few studies done that indicate that such matters improve the lives of youths. A common phrase you'll hear is "these extreme interventions save lives". But some of these "gold standard" studies are now under closer scrutiny and many professionals believe the studies themselves were flawed.

With all that said, my suggestion has been to ban these extreme measures for youths. I'm all for other forms of therapies and I'd welcome the inclusion of the eco-p approach.

So I'll give you one idea. By no means is this meant to be any sort of professional advice, it's a "Strawman Proposal", intended to be discussed, criticized, and revised:

What if - from an eco-p perspectvie - we did a study for troubled, trans-identifying (and otherwise) youths, in which we did the following:

- send them to a sort of outdoor summer camp.
- no access to wifi or the internet
- high quality diets, no sugar, limited refined carbs, and so on
- a lot of physical activity - in nature
- team building projects, and so on.

And then we measured mental health before and after such an intervention.

Again, I'm sure that some youths, in healthy environments, will identify as trans forever. But I think that some young people who experience what WHO refers to as "gender incongruence" might find relief through such less invasive interventions.

 

[icehorse]

To be quite honest, that sounds more like an American concern (not saying it’s only an American thing, obviously. That happens everywhere.)
The rest of the world doesn’t really question medical associations to such a degree because….well our medicine is largely bought by our government. In my country of Australiastan all medicine usually has to prove to be cost effective before the government even bothers. Private companies might but ehhh

So we don’t really have this cultural “overhanging profit margin affecting results” kind of thing to really worry about.
Not saying our drugs are cheap, probably cheaper than the US, generally speaking, though.

All this verbose crap to basically say, no organisation is without fault. No one will claim otherwise. (Well, I certainly hope so.)
This includes medical associations. But there is still a vast difference between citing a medical community and a news blog with a clear political agenda. Just for example.
One is made up of qualified professionals, who yes are all still fallible and can make mistakes. But still have enough expertise to have their opinion be taken more seriously about their topic of study. The other is a layman often using their own topic of expertise (journalism) to manipulate and even misconstrue actual medical data to fulfil their own goal/s.
Do not allow for the (clearly awful) profitability of US drug companies and their lobbies to allow you to become too cynical towards medical organisations. They’re not all bad

I think these are good points. It is however an interconnected, worldwide system to a large degree. As I mentioned a post or two ago, many European countries are now questioning studies they've relied upon, that were done in other countries.

 

[SomeRandom]

I think these are good points. It is however an interconnected, worldwide system to a large degree. As I mentioned a post or two ago, many European countries are now questioning studies they've relied upon, that were done in other countries.

Fair enough

I mean, to be fair, Trans care is fairly recent in (Western) medical science. It was studied upon early in the 20th century, but we lost all that information.
Thanks Nazis!!! (Not even kidding, that’s what books they burnt. Among others.)

Scientists will constantly question what they’ve relied upon and what they know. That’s part of the scientific method and indeed helps us get rid of outdated information. Some of which will be from outdated studies. With technology becoming more and more intense, I’m not really that surprised to hear organisations express concern for what studies they’re relying on.
Always gotta re-examine everything

Also too that humans are complex beings, never mind growing humans who are not “fully formed” yet.
So I fear this won’t be a case with clear cut answers for a while.
I also second the call that @Revoltingest was right about his answer

Interesting to note that the more “extreme” (if you like) medical treatments of trans youth have been the standard practice for intersex youth for decades now. Including surgery.
Indeed many intersex conditions are not diagnosable until the age where puberty is supposed to occur.

I don’t mean to change the topic, just find it interesting that what is considered standard practice and even shrugged off as “parents rights” are considered extreme when applied to another circumstance

 

[Saint Frankenstein]

I just want to state that the trans girls, like Jazz Jennings and Kim Petras, who got on puberty blockers at a young age, then cross sex hormones and then genital surgery - they will never be able to have an orgasm and basically have zero sex drive. Marci Bowers, who performed Jennings' genital surgery and who is a huge figure in trans health and activism, confirmed on video that Jennings will never be able to have an orgasm and that is true of all of the biological males who go from puberty blockers to cross sex hormones. Jennings also has spoken about these issues on her show and it's obviously a source of depression. It also causes a lot of complications for male to female genital surgery as there's simply not enough tissue for them to use, as it never develops in the first place. Their penis, testicles and prostate never develop and always remain childlike.

Now, that's for the MtFs. Not much is spoken about or is known about the FtMs who start off young, go on blockers and then testosterone and have genital surgery. I've looked for information, being an FtM myself, and couldn't find much.

I couldn't imagine never having an orgasm, never being able to have sex or even have a sex drive. That's a nightmare. There's also just not much for them to go back to if they decide it was a mistake, as many of these young transitioners often do (most of the detransitioners whose stories I know started when they were minors). They don't even have functional genitals. So there's good reasons not to do that to children.

 

[mikkel_the_dane]

A little context, this debate has been occurring across several threads here on RF, so it's understandable that some of the original context has been lost.

I've provided several links that show that many countries in Europe are rethinking the use of puberty blockers and surgeries on youths. There have been a few studies done that indicate that such matters improve the lives of youths. A common phrase you'll hear is "these extreme interventions save lives". But some of these "gold standard" studies are now under closer scrutiny and many professionals believe the studies themselves were flawed.

With all that said, my suggestion has been to ban these extreme measures for youths. I'm all for other forms of therapies and I'd welcome the inclusion of the eco-p approach.

So I'll give you one idea. By no means is this meant to be any sort of professional advice, it's a "Strawman Proposal", intended to be discussed, criticized, and revised:

What if - from an eco-p perspectvie - we did a study for troubled, trans-identifying (and otherwise) youths, in which we did the following:

- send them to a sort of outdoor summer camp.
- no access to wifi or the internet
- high quality diets, no sugar, limited refined carbs, and so on
- a lot of physical activity - in nature
- team building projects, and so on.

And then we measured mental health before and after such an intervention.

Again, I'm sure that some youths, in healthy environments, will identify as trans forever. But I think that some young people who experience what WHO refers to as "gender incongruence" might find relief through such less invasive interventions.

Yeah, and I read an article in Danish, where we do not have the American issuses of private medicine.
The pathis as follows.
Get a referrel from your GP.
Be tested and interview by speicalists.
Get your case for a panel of specialists.
If they approve you get puperty blockers.

Now one of the MD incloved as a specialists explained that it was the best of in effect the "least worst" they could do now and they are aware they have to reevaluate as more data comes in.
So the answer given is what @Revoltingest gave at the start at the thread and I aggreed with. This is not hard exact science. And your subjective standard in your OP: "It seems to me that pro-castration advocates have not proved their case with extraordinarily good evidence." is that, subjective.

Learn that not all science is simple and it takes time.

 

[Koldo]

A little context, this debate has been occurring across several threads here on RF, so it's understandable that some of the original context has been lost.

I've provided several links that show that many countries in Europe are rethinking the use of puberty blockers and surgeries on youths. There have been a few studies done that indicate that such matters improve the lives of youths. A common phrase you'll hear is "these extreme interventions save lives". But some of these "gold standard" studies are now under closer scrutiny and many professionals believe the studies themselves were flawed.

With all that said, my suggestion has been to ban these extreme measures for youths. I'm all for other forms of therapies and I'd welcome the inclusion of the eco-p approach.

So I'll give you one idea. By no means is this meant to be any sort of professional advice, it's a "Strawman Proposal", intended to be discussed, criticized, and revised:

What if - from an eco-p perspectvie - we did a study for troubled, trans-identifying (and otherwise) youths, in which we did the following:

- send them to a sort of outdoor summer camp.
- no access to wifi or the internet
- high quality diets, no sugar, limited refined carbs, and so on
- a lot of physical activity - in nature
- team building projects, and so on.

And then we measured mental health before and after such an intervention.

Again, I'm sure that some youths, in healthy environments, will identify as trans forever. But I think that some young people who experience what WHO refers to as "gender incongruence" might find relief through such less invasive interventions.

You have a person in front of you that has been telling you for year(s) that they see themselves as belonging to another genre, and they want a body that matches that gender.

So, you burn the bridge that allows them to far more easily achieve that goal and force them to engage in some outdoor activity to improve their mental health...with what basis that this will suddenly change their minds?

It doesn't sound like a good idea, even on paper. Shouldn't you be testing that idea of yours before burning the bridge?

By the way, your outdoor summer camp sounds awful to me. This is exactly the sort of thing that would have decreased my mental health back when I was a teenager, and I am cisgender.

 

[Guitar's Cry]

Like many other medical decisions, there's no one-fits-all approach. Whatever my personal feelings towards children receiving puberty blockers or surgery (which I don't think actually happens, or is ridiculously infrequent), it's not my choice and it should be up the families and their chosen medical professionals.

 

[Guitar's Cry]

I just want to state that the trans girls, like Jazz Jennings and Kim Petras, who got on puberty blockers at a young age, then cross sex hormones and then genital surgery - they will never be able to have an orgasm and basically have zero sex drive. Marci Bowers, who performed Jennings' genital surgery and who is a huge figure in trans health and activism, confirmed on video that Jennings will never be able to have an orgasm and that is true of all of the biological males who go from puberty blockers to cross sex hormones. Jennings also has spoken about these issues on her show and it's obviously a source of depression. It also causes a lot of complications for male to female genital surgery as there's simply not enough tissue for them to use, as it never develops in the first place. Their penis, testicles and prostate never develop and always remain childlike.

Now, that's for the MtFs. Not much is spoken about or is known about the FtMs who start off young, go on blockers and then testosterone and have genital surgery. I've looked for information, being an FtM myself, and couldn't find much.

I couldn't imagine never having an orgasm, never being able to have sex or even have a sex drive. That's a nightmare. There's also just not much for them to go back to if they decide it was a mistake, as many of these young transitioners often do (most of the detransitioners whose stories I know started when they were minors). They don't even have functional genitals. So there's good reasons not to do that to children.

Do folks like Jennings, aside from their regret towards a loss of sex drive and orgasm, express regret for the whole thing?

 

[icehorse]

Yeah, and I read an article in Danish, where we do not have the American issuses of private medicine.
The pathis as follows.
Get a referrel from your GP.
Be tested and interview by speicalists.
Get your case for a panel of specialists.
If they approve you get puperty blockers.

Now one of the MD incloved as a specialists explained that it was the best of in effect the "least worst" they could do now and they are aware they have to reevaluate as more data comes in.
So the answer given is what @Revoltingest gave at the start at the thread and I aggreed with. This is not hard exact science. And your subjective standard in your OP: "It seems to me that pro-castration advocates have not proved their case with extraordinarily good evidence." is that, subjective.

Learn that not all science is simple and it takes time.

An overriding principle in medicine is this: "First, do no harm."

I agree that science is complex, imperfect, dynamic, and sometimes subjective.

In those cases, I'm advocating the use of the "do no harm" principle.

 

[icehorse]

So, you burn the bridge that allows them to far more easily achieve that goal and force them to engage in some outdoor activity to improve their mental health...with what basis that this will suddenly change their minds?

First, the bridge is delayed, not burned.

Second, my strawman proposal was not as simple as "outdoor activities". It was more like: "remove as many unhealthy environmental factors as possible" and see what happens. Seems like a very safe approach with a potentially huge upside and almost no down side.

 

[mikkel_the_dane]

An overriding principle in medicine is this: "First, do no harm."

I agree that science is complex, imperfect, dynamic, and sometimes subjective.

In those cases, I'm advocating the use of the "do no harm" principle.

Yeah, you do that. And you understand it one way and others understand it differently. And then time will sort it out.

 

[mikkel_the_dane]

First, the bridge is delayed, not burned.

Second, my strawman proposal was not as simple as "outdoor activities". It was more like: "remove as many unhealthy environmental factors as possible" and see what happens. Seems like a very safe approach with a potentially huge upside and almost no down side.

Possible down sides. You subject the kids to something who might not be relevant for them all and cause some of them stress. Remember do no harm.

 

[Saint Frankenstein]

Do folks like Jennings, aside from their regret towards a loss of sex drive and orgasm, express regret for the whole thing?

"The whole thing" could mean many different things. She could regret transitioning all together, she could regret doing it so young, she could regret doing it before an audience of millions, etc. We don't know, probably because no one is really asking her. Jennings is a classic case of an overbearing, toxic mother who lives vicariously through her children and a weak, ineffectual father. So it will be hard for her to assert her authentic self, whatever it may be.

 

[Guitar's Cry]

"The whole thing" could mean many different things. She could regret transitioning all together, she could regret doing it so young, she could regret doing it before an audience of millions, etc. We don't know, probably because no one is really asking her. Jennings is a classic case of an overbearing, toxic mother who lives vicariously through her children and a weak, ineffectual father. So it will be hard for her to assert her authentic self, whatever it may be.

That's reasonable. When it comes to celebrities it seems a lot of things they do can lead to regret and depression.

 

[Koldo]

First, the bridge is delayed, not burned.

Once the secondary sexual characteristics develop, you will need to undergo a lot of procedures to revert those changes. You keep disregarding the significance of this factor.

Second, my strawman proposal was not as simple as "outdoor activities". It was more like: "remove as many unhealthy environmental factors as possible" and see what happens. Seems like a very safe approach with a potentially huge upside and almost no down side.

The downside is that: you have no idea if this is going to be sufficient, you have provided no basis to believe it will be, and you have no alternative if it doesn' work.

 

[Saint Frankenstein]

That's reasonable. When it comes to celebrities it seems a lot of things they do can lead to regret and depression.

Right. That's a big part of why I don't support referring to her as male or dredging up her male name, because she hasn't made any announcement that she isn't a woman or changed who she is. It's just apparent that she's very depressed and it's obvious that at least some of the factors of her medical transition are causing that depression, but there's clearly other issues going on. Still, loss of sexual function (or rather, never having it in the first place) is a huge thing in of itself. I'd be eternally depressed over it.

 

[SomeRandom]

An overriding principle in medicine is this: "First, do no harm."

I agree that science is complex, imperfect, dynamic, and sometimes subjective.

In those cases, I'm advocating the use of the "do no harm" principle.

I was curious so I tried googling “Chemical castration as a medical means.”
It came up with various results that basically said that it was used to reduce libido, in the past used as a way to punish multiple sex crimes (not anymore though?) and to treat certain forms of cancer.

So I did another search, this time including the term “trans medicine.”
The results were far more politicised. Which I guess isn’t that shocking, for obvious reasons.

But my results did show that multiple studies have apparently shown that as of late, this “chemical castration” or more specifically puberty blockers seemed to be tolerated well and even reduced suicidal tendencies and increased mental health affects, with no long term measurable affects.
Showing me that the usage of the term “chemical castration” is considered to be different in the circumstances. Which may just be a case of using similar chemicals for differing results. Which does happen when using drugs, I suppose. A bit above my pay grade though lol

https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/camh.12437

Systematic Review: Puberty suppression with GnRH analogues in adolescents with gender incongruity - Journal of Endocrinological Investigation

Context Gender incongruence is defined as disharmony between assigned gender and gender identity. Several interventions are liable in this case including genital affirming surgery among other surgical interventions such as harmonization, and also the use of gonadotropin-releasing hormone...

link.springer.com

Granted, as I alluded to earlier, it is still pretty early days.
And as @Saint Frankenstein pointed out, this may not always the case. There may be very large detrimental affects.
Now I can’t comment one way or the other, since I am wholly unfamiliar with the situations that he is referring to. I can only hope the individuals referenced are living their best lives.

So it may indeed need to be a case of “further research is required.”
Unfortunately, we can’t get there without some form of “experimentation.” And I can understand the hesitancy when it comes to children in the mix.

That all said, medicine isn’t a one size fits all. There may indeed be individuals who end up with rather detrimental life long affects. Maybe not all, but a portion. I honestly don’t know. It will take time to gather the information and I fear politics will interfere with that. On both sides

But like all medicine, you will have to weigh up the pros and the cons. And decreasing suicidal tendencies in youth is pretty high up on my list of pros, to be honest.
Though again like medicine in general, it looks like this will need to be a more “case by case basis.”

 

[sun rise]

Yawn, I see the standard of care advocated by responsible and science-based organizations is being ignored in favor of attacking a straw man position that is outside the bounds of proper care. This is, of course, the internet at its "finest".

 

[Guitar's Cry]

Right. That's a big part of why I don't support referring to her as male or dredging up her male name, because she hasn't made any announcement that she isn't a woman or changed who she is. It's just apparent that she's very depressed and it's obvious that at least some of the factors of her medical transition are causing that depression, but there's clearly other issues going on. Still, loss of sexual function (or rather, never having in the first place) is a huge thing in of itself. I'd be eternally depressed over it.

It would certainly impact me too. It is definitely something that needs to be considered by the people seeking this intervention.

 

[icehorse]

Yawn, I see the standard of care advocated by responsible and science-based organizations is being ignored in favor of attacking a straw man position that is outside the bounds of proper care. This is, of course, the internet at its "finest".

Do you think the medical profession is always responsible and never engages in profiteering or other questionable activities?

If so, can you explain why US healthcare is so expensive and so poorly rated on a worldwide basis?

And if not, can you explain how you go about deciding when they're being responsible and when they're not?

==

As for strawman arguments, the factual claims here are that the incidence of identifying as trans is rising at enormous rates, and that thousands of youths are undergoing puberty blocking and/or gender related surgeries. How are those claims strawman claims?