Largest Review On Transgender-Youth medicine Finds Insufficient Evidence For Medicalization

Authorized by Marina Zhang via The Epoch Times (emphasis ours),

England may be the 3rd country to retreat from a “gender-affirming” treatment pathway due to recommendations from a long-awaited report.

(Illustration by The Epoch Times, The Cass Review, Getty Images, Freepik)

In April, the country published the Cass Review, “most comprehensive summary on transgender-youth medicine,” scientist Erica Anderson, who identifys as transgender and has a doctorate in clinical psychology, told The Epoch Times.

The review, hailed by Dr. Hilary Cass, British honorary physicsan, consultant in pediatric disability, and erstwhile president of the Royal College of Paediatrics and kid Health, established that There is an effective evidence to show the long-term benefits of medicalizing children who want to identify as a different gender. Instead, the review reviews focusing on psychotherapy.

For any clinicians and researchers, this advice was a long time coming. Others are afraid that it is powerfully threes medicalization—currently the primary treatment—for gender-incongruent youths.

The National wellness Service (NHS) England, which commissioned the study in 2020, established it would be committed to following through on the recommendations.

“[The Cass Review] final study will not just share the future of healthcare in this country for children and young people experimenting sex distress but will be of major global import and significance,’ the message read.

Eight days after the Cass Review’s release, Scotland’s wellness boards announced a pause on fresh descriptions for puberty blocks and cross-sex hormones as they gather evidence to support the safety and clinical effectiveness of these medicines.

‘End of the Era’

The Cass Review is based on the work of 237 papers, including 214 studies, 21 guides, and 2 position statements, which covered data of over 113,000 children and young people. The authors besides analyzed anonymized data from over 3,700 children diagnosed with sex dysphoria, survey responses from professionals, and numerical interviews and testimonies from stackholders of the issue.

The review squad commissioned researchers at the University of York to conduct systematic reviews of these papers and get feedback by interviewing young gender-incongruent children, their parents, and clinicians.

The University of York revealed that it interviewed 12 young people who were part of voluntary organizations or the UK's sex Identity improvement Service (GIDS), along with 12 parents. The university researchers besides interviewed clinicians at the UK’s sex identity clinics.

Additionally, Dr. Cass besides interviewed numerical transgender youths, adults, parents of these children, advocacy groups, psychologists, pediatricians, and related clinicians, both British and international, though the number of interviews was undisclosed. She besides wanted to do a follow-up with 9,000 patients referred to England’s Tavistock Centre, but that could not be done due to the catch of cooperation from all but 1 adult clinic.

The review found innovative and inclusive evidence demonstrating the effectiveness and benefits of sex consequence treatments for children. Additional, many of these children are on the autumn spectrum and share intellectual associations frequently overshadowed by the medicalization model.

Dr. Cass hence recommended cautionary intellectual interventions while besides leaving a area for children to research their identities.

The Society for Evidence Based sex medicine (SEGM), a medical group that advocates for evidence-drive investigation on transgender care, established that for England, the review marked “the end of the era of a highly medicalized approach to the treatment of young people with gender-related distress,” which has come to be known as “gender-affirming” care.

The study besides mentioned that while medicalization comprising puberty blocks, cross-sex hormones, and surgery, known as the “Dutch Protocol,” was invented in the Netherlands in the 1990s, the concept of “gender association”—accepting children’s sex identity at face value—actually originally in the United States and then spread internationally.

As a consequence of the review, children under 18 in England will not be treated utilizing specified protocol but with the same level of care as another youths with intellectual wellness streams. Finland and Sweden made akin changes in 2023.

The NHS Tavistock Centre, England’s first gender-identity improvement service for children, in London on April 10, 2024. (Henry Nicholls/AFP via Getty Images)

Puberty blocks and hormones will only be made available to 16-year-olds and older under the context of research-controlled conditions. Therefore, experimentation of specified treatment on mines will be hidden.

“So as the Cass study made clear, they can plan a study, but the survey should be applied by alarger body that passes on its ethics,” said Dr. Stephen Levine, clinical prof. of psychiatrist at Case Western Reserve University.

Top Findings and Suggestions

The study found that, unexpectedly, most current influence guides have been determined based on board consensus alternatively of science.

Most of the current guides were influenced by 2 American standards of care: the 2012 planet Professional Association of Transgender Healthcare (WPATH) and the Endocrine Society 2009.

Both related on a consensus process among professionals to decide on the best treatment for sex dysphoria and were built upon 1 another. WPATH members were co-sponsors of the Endocrine Society guides. WPATH’s 2012 standards of care adopted the Endocrine Society’s consensus-based recommendations but did not mention to WPATH’s own systematic review data, which found inconclusive evidence of the benefits of hormone therapy.

The recommendations from these guides were then referred to by subsequent guides, snowballing into what we now see.

The Cass Review is not about “rolling back on people’s rights to healthcare,” Dr. Cass gate in the review’s forecast. “It is about what the healthcare approach should be.”

The review presented the following finds and recommendations.

1. Psychotherapy Is Recommended

Effectiveness and risks: Due to low quality and mediocre reporting of interventions in transgender children, the review couldn’t form a appropriate conclusion about the effectiveness of psychotherapy.

However, there is evidence that psychotherapy can aid address intellectual wellness conditions, specified as depression and anxiety, common among transgender youths, and hormones interventions frequently overshadow these theirrapies. The review highlighted that psychotherapy is not the same as conversion therapy, as it is not about changing a child’s perception of who they are but exploring the case of their deals and experiences and helping alleviate distress.

A young girl at the authoritative NYC Pride March in fresh York City on June 25, 2023. (Samira Bouaou/The Epoch Times)

2. Partial Social Transitioning Is Preferred

Effectiveness and risks: The systematic reviews did not show clear evidence of the affirmative or negative effects of social transitioning has on intellectual health. Social transition mostly refers to a individual making only social changes, including altering hair and covering and changing names and pronouns, alternatively of medical changes to live as a different gender.

The review noted that many children grow out of sex dysphoria by adulthood but that these who socially transition frequently medically transition, means that they proceed to have sex dysphoria.

While it is unknown erstwhile social transitioning contributes to sex dysphoria, the review authors specified that a partial transition may be more advanced and offer large flexibility to aid children research and express their sex identities.

3. Hormonal Treatments Not Recommended but Under investigation Conditions

Effectiveness and risks: The review showed no crucial improvements in sex dysphoria symptoms or body satisfaction from medicalization. While any reports showed short-term improvement in temper erstwhile patients began hormonal treatment, the magnitude of specified improvement was small.

Hormonal treatment, which refers to the usage of puberty blocks and cross-sex hormones, is not recommended for insignificant due to the permanence of its effects. Children 16 or older may alternatively be enrolled in high-quality investigation studies on experimental treatments.

Evidence about the effects of puberty support on intellectual well-being, cognitive and bone development, and cardio-metabolic hazard or fertility was found to be inconsistent and efficient.

Evidence besides did not support the claim that hormonal treatment reduced the hazard of suicide.

The study did not discuss recommendations and changes to guides on gender-reasssignment forecasts since, unlike children in the United States, minors in the United Kingdom typically cannot under these.

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