Reuters Special Report: Little Scientific Evidence For Affirmative Care – Podcast

IN TREATMENT: Ryace Boyer, a 14-year-old high-school student, prepares to take the female hormone estrogen as part of her gender-affirming medical care. REUTERS/Megan Jelinger

The Good Creation Podcast – Little Scientific Evidence For Affirmative Care

Podcast Script

From my perspective, there are things in this Reuters Special Report that I disagree with, for example, the use of the fictional phrase “sex-assigned at birth.” Sex is not assigned at birth. It is recognized at birth.

I nevertheless am glad to see the legacy media beginning to question the widespread Western practice of “gender-affirming care.” Better late than never.

Let me recite the headlines of this article and a few important paragraphs.


As more transgender children seek medical care,
families confront many unknowns.

Across the United States, thousands of youths are lining up for gender-affirming care. But when families decide to take the medical route, they must make decisions about life-altering treatments that have little scientific evidence of their long-term safety and efficacy.

...families that go the medical route venture onto uncertain ground, where science has yet to catch up with practice. While the number of gender clinics treating children in the United States has grown from zero to more than 100 in the past 15 years – and waiting lists are long – strong evidence of the efficacy and possible long-term consequences of that treatment remains scant.
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More broadly, no large-scale studies have tracked people who received gender-related medical care as children to determine how many remained satisfied with their treatment as they aged and how many eventually regretted transitioning. The same lack of clarity holds true for the contentious issue of detransitioning, when a patient stops or reverses the transition process.

The National Institutes of Health, the U.S. government agency responsible for medical and public health research, told Reuters that “the evidence is limited on whether these treatments pose short- or long-term health risks for transgender and other gender-diverse adolescents.” The NIH has funded a comprehensive study to examine mental health and other outcomes for about 400 transgender youths treated at four U.S. children’s hospitals. However, long-term results are years away and may not address concerns such as fertility or cognitive development.
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In its latest Standards of Care, released in September, WPATH notes the paucity of research supporting the long-term effectiveness of medical treatment for adolescents with gender dysphoria. As a result, the guidelines say, “a systematic review regarding outcomes of treatment in adolescents is not possible.” The Endocrine Society, in its own guidelines, acknowledges the “low” or “very low” certainty of evidence supporting its recommendations.
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Dr Annelou de Vries, a specialist in child and adolescent psychiatry, is one of the Dutch researchers whose early work established the importance of rigorous patient assessments before starting medical treatment. She said that while she worries about the growing number of children awaiting treatment, the graver sin is to move too fast when puberty blockers and hormones may not be appropriate.

“The existential ethical dilemma in transgender care is between on one hand the (child’s) right for self-determination,” de Vries said. “On the other hand, the do-not-harm principle of medical intervention. Aren’t we intervening medically in a developing body where we don’t know the results of those interventions?” In the United States, in particular, she said, “the transgender right or child’s right seems to be put forward more strongly.” De Vries helped write the section on adolescents in WPATH’s updated Standards of Care. She said she was gratified that language stressing the importance of rigorous patient assessments remained.

In interviews with Reuters, doctors and other staff at 18 gender clinics across the country described their processes for evaluating patients. None described anything like the months-long assessments de Vries and her colleagues adopted in their research.
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Reuters interviewed parents of 39 minors who had sought gender-affirming care. Parents of 28 of those children said they felt pressured or rushed to proceed with treatment.

Kate, a 53-year-old mother in New Jersey, said she and her husband were shocked in November 2020 when their 13-year-old told them he was transgender. The child, assigned female at birth, had always played with other girls and had never expressly identified as a boy. They just thought their child was a “tomboy.” Now, they learned, he had chosen a male name and wanted to start puberty blockers and get breast-removal surgery.

After an initial one-on-one consultation of little more than an hour with the teen, a psychiatrist said he was a good candidate for puberty blockers, Kate said. An endocrinologist recommended the same after talking with the family for 15 minutes. Kate and her husband also attended a parents’ support group organized by a local gender therapist. Through it all, Kate said, “the message was, let your kid drive the bus. Wherever they lead you, that’s what you should do.”
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Some gender-care professionals complain that suicide risk is too often used to pressure and even frighten parents into consenting to treatment. “I think it’s irresponsible for clinicians to do that,” said Anderson, the former president of WPATH’s U.S. chapter. “As a clinical psychologist, I don’t do a suicide assessment by membership in a class. The level of risk varies tremendously across individuals.”

De Vries, the Dutch researcher, told Reuters there is no evidence that “providing care immediately leads to a decline in self harm or would prevent suicide.”
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In a 2018 study published in the medical journal Clinical Pediatrics, researchers at Yale University noted a sharp increase in the off-label use of puberty blockers and said these drugs “have not been thoroughly investigated in populations with normally timed puberty.”

In Texas earlier this year, bone scans indicated that a child, 15 years old at the time, had osteoporosis after 15 months on puberty blockers. The teen’s mother, who asked not to be identified because she works at the hospital where her child was treated, said she thought she had done everything right when her teen came out as a transgender girl. But after the bone scan results, reviewed by Reuters, she said she regretted putting her child on puberty blockers. She stopped the Lupron injections and wouldn’t agree to hormone therapy.
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A Dec. 17, 2020, adverse event report to the FDA describes a 15-year-old patient taking Lupron for gender therapy. The patient had a history of “major depressive disorder” and a family history of depression. The patient experienced “mental health deterioration” while on Lupron and attempted suicide twice. AbbVie (a pharmaceutical co.) wrote in the report to the FDA that “there is no reasonable possibility” that the adverse events were related to Lupron. The company did not elaborate.

Dr Brad Miller, division director of pediatric endocrinology at the University of Minnesota Medical School and M Health Masonic Children’s Hospital, expressed surprise at the number of adverse event reports Reuters found. He said he was particularly concerned because doctors prescribe puberty blockers for transgender children, who are already at higher risk of mental health problems.

Miller and several other doctors told Reuters they had repeatedly asked AbbVie, Endo and other makers of puberty blockers to seek FDA approval for the drugs in treating gender dysphoria in children and to conduct clinical trials to establish the drugs’ safety for such use. They said the companies always declined. “They would say it would cost a lot of money to get approval,” Miller said. “And they were not interested in going there because (transgender treatment) was a political hot potato.”


Source: Reuters.com

There is much more in the Reuters report. It tries to “balance” the reporting above but, from my Christian first principles perspective, I don’t see how that is possible.

Throughout the article the story of a male to “female” student named Ryace is documented. Although the vast majority of cases today are females transitioning to “male.”

MOTHER AND DAUGHTER: Ryace says she forgives her mother, Danielle, for making her conceal her identity for so long. REUTERS/Megan Jelinger

A PAINFUL VICTORY: When Ryace was crowned Horse Princess at a local fair, some members of the crowd grumbled. REUTERS/Megan Jelinger

Read the whole thing carefully and send me any questions you might have about my Classic Christian position on the issue.

blog@blueridgemountain.life

Companion Post

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What Are We Doing To Our Children?

Who Is The Conversion Therapist? – Podcast

The Good Creation Podcast – Who Is The Conversion Therapist?

Podcast Transcript

Dr. Randi Ettner, the chief psychologist at the Chicago Gender Center, describes the standard of care treatment plan promoted by transgender activists, otherwise known as the Affirmative Care Model“:

•  Changes in gender expression and role, consistent with one’s gender identity (also referred to as social role transition).
•  Psychotherapy for purposes such as addressing the negative impact of stigma, alleviating internalized transphobia, enhancing social and peer support, improving body image, promoting resiliency, etc.
•  Hormone therapy to feminize or masculinize the body.
•  Surgery to alter primary and/or secondary sex characteristics.1“Declaration of Randi Ettner, Ph.D., U.S. District Court, Middle District of North Carolina, Case 1:16-cv-236-TDS-JEP, p. 5.”

This plan is often called transitioningbut some transgender activists regard that term as stigmatizing and inaccurate. From the perspective of the transgender person they are simply engaged in a process of “settling in to themselves” or “coming home” to what they always were inside.2“PFLAG, Our Trans Loved Ones: Questions and Answers for Parents, Families, and Friends of People Who Are Transgender and Gender Expansive (2008, 2015), p. 9, https://www.pflag.org/ourtranslovedones.”

A similar linguistic jujitsu is at work when activists prefer to speak of gender-affirming therapies instead of sex reassignment therapies. (Since when did it become the primary job of doctors to affirm?). For women these affirming therapies mean life-long testosterone, double mastectomies and the creation of a penis (phalloplasty). For men, life-long estrogen, gonadectomy, penectomy, and the creation of a vagina (vaginoplasty). Here are some affirming treatment details:

“Sex reassignment surgeries available to the MTF3male to female transsexual persons consist of gonadectomy, penectomy, and creation of a vagina. The skin of the penis is often inverted to form the wall of the vagina. The scrotum becomes the labia majora. Cosmetic surgery is used to fashion the clitoris and its hood, preserving the neurovascular bundle at the tip of the penis as the neurosensory supply to the clitoris. Most recently, plastic surgeons have developed techniques to fashion labia minora. Endocrinologists should encourage the transsexual person to use their tampon dilators to maintain the depth and width of the vagina throughout the postoperative period until the neovagina is being used frequently in intercourse. Genital sexual responsivity and other aspects of sexual function should be preserved after genital sex reassignment surgery…. Another major effort is the removal of facial and masculine-appearing body hair using either electrolysis or laser treatments. Other feminizing surgery, such as that to feminize the face, is now becoming more popular.

Sex reassignment surgeries available to the FTM4female to male transsexual persons have been less satisfactory. The cosmetic appearance of a neopenis is now very good, but the surgery is multistage and very expensive. Neopenile erection can be achieved only if some mechanical device is imbedded in the penis, e.g. a rod or some inflatable apparatus. Many choose a metaidoioplasty that exteriorizes or brings forward the clitoris and allows for voiding while standing. The scrotum is created from the labia majora with a good cosmetic effect, and testicular prostheses can be implanted. These procedures, as well as oophorectomy, vaginectomy, and complete hysterectomy, are undertaken after a few years of androgen therapy and can be safely performed vaginally with laparoscopy. 

The ancillary surgery for the FTM transition that is extremely important is the mastectomy. Breast size only partially regresses with androgen therapy. In adults, discussion about mastectomy usually takes place after androgen therapy is begun. Because some FTM transsexual adolescents present after significant breast development has occurred, mastectomy may be considered before age 18.”5“Hembree et al., “Endocrine Treatment of Transsexual Persons,” 3149.”

Again, like I did in a previous podcast I must ask, who is engaged in conversion therapy here?

Is it the one who is trying to help a person align their thoughts and feelings with the body that I believe God created and gave to them as mediated through their parents or the professional who disregards the body and proposes irreversible radical surgeries combined with life-long hormone treatments in hopes of aligning the outer body with a patient’s inner desires?

Who is the conversion therapist?

Gender Identity Ideologues pin that label on those clinicians and pastors who try to help an individual become more comfortable with their immutable biological sex. These concerned professionals and pastors counsel them not to transition away from their birth sex. It’s called Talk Therapy. And it is very effective, especially for children with gender dysphoria. Trans Activists and Gender Identity Ideologues regard these efforts as immoral and professional clinicians are forbidden in some states and other countries from steering individuals toward accepting their birth sex.

Leveling the charge of “conversion therapist” packs quite a rhetorical punch because these therapeutic techniques are said to be just like some of the therapies used in the past to “convert” homosexuals. But that’s not true. It’s Talk Therapy! And also, as I’ve said before homosexuals don’t deny their biological sex. This is different. Helping someone align their thoughts and desires with the indisputable facts of their body is not converting them into someone different. Leveling the charge of “conversion therapist” on those professionals or pastors who don’t “affirm” is Orwellian doublespeak. Don’t believe it. And push back. Firmly. Even if you are called a bigot. Do it anyway.

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I’m a Classic Christian and regard Gender Ideology as anti-creational to the core. This blog & podcast is about “God’s Good Creation.” That’s why I’m writing about Gender Ideology. And “speaking up” as I’m confident Jesus would.

"Have you not read that the one who made them at the beginning 'made them male and female.'" [Matt 19:4]

The Natchez by Delacroix – 1835
Oil on Canvas
Courtesy of the Metropolitan Museum of Art

Love refuses to affirm confusion.

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Grand View Point Overlook

Canyonlands National Park is listed as the most dangerous park in the entire NP system. Why? Because in the summer time humans occasionally “overstay their welcome.” And pack not nearly enough water. You have been warned.

Which is one reason why late March is a great time to visit.

Enjoy.

Grand View Point Overlook

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God’s Beauty