Apology for the Priesthood Ban / "March of Dimes Syndrome" / "Mission Creep" / "Spencer's Law"

[smac97]

26 minutes ago, Calm said:

But if the issue is electively cutting off healthy body parts,

What body parts?

Do you you see any distinctions between male circumcision and a penectomy?  Or a mastectomy? 

26 minutes ago, Calm said:

then why aren’t you talking about it as one surgery of the collection of surgeries you find inappropriate as elective removal of healthy body parts…at least enough to say “yes, I apply the same standards to it” as in we need to look at comorbidities, etc associated with it in making decisions about the appropriateness of such surgery.

Well, we can have that discussion if you like.

26 minutes ago, Calm said:

It qualifies as electively removing healthy body parts, does it not?

Yes.

26 minutes ago, Calm said:

If you don’t include circumcision in this discussion or do not apply the same standards to it for some reason, it would appear that it is not a discussion focused on the issue of cutting off healthy body parts, but something else, something more than just the removal of healthy body parts. 

The discussion has been of "gender-affirming" medical treatments.  Circumcision is not that.

Are the folks trying to inject circumcision into this discussion opposed to circumcision?  It seems like an attempt at Whataboutism:

Quote

Whataboutism or whataboutery (as in "what about ...?") is a pejorative for the strategy of responding to an accusation with a counter-accusation instead of a defense against the original accusation.

From a logical and argumentative point of view, whataboutism is considered a variant of the tu-quoque pattern (Latin 'you too', term for a counter-accusation), which is a subtype of the ad-hominem argument.^[1][2][3][4]

The communication intent is often to distract from the content of a topic (red herring). The goal may also be to question the justification for criticism and the legitimacy, integrity, and fairness of the critic, which can take on the character of discrediting the criticism, which may or may not be justified. Common accusations include double standards, and hypocrisy, but it can also be used to relativize criticism of one's own viewpoints or behaviors. (A: "Long-term unemployment often means poverty in Germany." B: "And what about the starving in Africa and Asia?").^[5] Related manipulation and propaganda techniques in the sense of rhetorical evasion of the topic are the change of topic and false balance (bothsidesism).^[6]

I think some parents and doctors have been unduly influenced by ideological and/or sociopolitical pressures to pursue these medical treatments on children, without having given sufficient consideration to the issues I have previously noted:

• Comorbidities. 
• Informed consent. 
• Compromised assessments of the best interests of the child. 
• Irreversibility. 
• Sterilization. 
• Cutting off healthy body parts. 
• Longitudinal studies essentially absent. 
• Lifelong medical regimens. 
• Massive ideological/sociopolitical influences/pressures on medical care. 
• Massive social contagion risks. 
• Massive risk of financial devastation for the individual (and burden on society).

I have spoken about most of these at some length in various threads. 

How many of these are applicable to circumcision?

Thanks,

-Smac

Edited October 10, 2024 by smac97

[california boy]

10 minutes ago, smac97 said:

 

The discussion has been of "gender-affirming" medical treatments.  Circumcision is not that.

 

Thanks,

-Smac

Oh so you don't have a problem with cutting off body parts.   So what part of transitioning  to do you have a problem with???

[Calm]

44 minutes ago, smac97 said:

What body parts?

Healthy ones according to you. 
 

Quote

Are the folks trying to inject circumcision into this discussion opposed to circumcision[gender affirming care?]?  It seems like an attempt at Whataboutism:

Not really.  It appears to me a major part of your argument is founded on being opposed to elective removal of healthy body parts.  That is why you included the discussion on the woman who wants her healthy legs to be remove or paralyzed, I thought.

Am I correct in thinking that one of your major concerns with surgical transitioning is the elective removal of healthy body parts?  If not, why did you bring up the example of the woman and ask if someone was okay with removing of her limb (or whatever the specifics of your question was)?

Quote

How many of these are applicable to circumcision?

At least 6 I am thinking.  Possibly 8, but I may be out of date.

Edited October 11, 2024 by Calm

[MustardSeed]

3 hours ago, smac97 said:

Okay.  So "electively removing healthy body parts of children" and "electively sterilizing children" would be acceptable in your view?

Thanks,

-Smac

Yes, for the purpose of clear dialogue minus inflammatory language. 

[smac97]

35 minutes ago, california boy said:

Oh so you don't have a problem with cutting off body parts.  So what part of transitioning  to do you have a problem with???

See my bullet list.

[Analytics]

3 hours ago, smac97 said:

I Thought I Was Saving Trans Kids. Now I’m Blowing the Whistle

...

The bona fides of the author are noteworthy to me.

Surely you aren’t quoting this article because as a general rule you especially value the opinion of queer women who are more than liberal Bernie Sanders and are married to transmen, are you? Rather, you are quoting this article because it agrees with your preconceptions, right? If she didn’t agree with you, her bona fides would be the basis of her biases and not reasons to especially value her opinion, right?

From my perspective, her opinion is anecdotal and myopic, and I’m skeptical of whether her opinion provides an accurate representation of the clinic where she worked, much less is something that can be extrapolated to describe what’s happening at the other 99 clinics.

In any case, the New York Times wrote an article about what you quoted. For your consideration:

How a Small Gender Clinic Landed in a Political Storm

Quote

Washington University’s youth gender clinic in St. Louis, like others around the world, was overwhelmed by new patients and struggled to provide them with mental health care.

By Azeen Ghorayshi

Reporting from St. Louis

• Published Aug. 23, 2023Updated Aug. 29, 2023

The small Midwestern gender clinic was buckling under an unrelenting surge in demand.

Last year, dozens of young patients were seeking appointments every month, far too many for the clinic’s two psychologists to screen. Doctors in the emergency room downstairs raised alarms about transgender teenagers arriving every day in crisis, taking hormones but not getting therapy.

But as the number of these patients soared, the clinic became overwhelmed — and soon found itself at the center of a political storm. In February, Jamie Reed, a former case manager, went public with explosive allegations, claiming in a whistle-blower complaint that doctors at the clinic had hastily prescribed hormones with lasting effects to adolescents with pressing psychiatric problems.

Ms. Reed’s claims thrust the clinic between warring factions. Missouri’s attorney general, a Republican, opened an investigation, and lawmakers in Missouri and other states trumpeted her allegations when they passed a slew of bans on gender treatments for minors. L.G.B.T.Q. advocates have pointed to parents who disputed her account in local news reports and to a Washington University investigation that determined her claims were “unsubstantiated.”

The reality was more complex than what was portrayed by either side of the political battle, according to interviews with dozens of patients, parents, former employees and local health providers, as well as more than 300 pages of documents shared by Ms. Reed.

Some of Ms. Reed’s claims could not be confirmed, and at least one included factual inaccuracies. But others were corroborated, offering a rare glimpse into one of the 100 or so clinics in the United States that have been at the center of an intensifying fight over transgender rights.

The turmoil in St. Louis underscores one of the most challenging questions in gender care for young people today: How much psychological screening should adolescents receive before they begin gender treatments?

Shaped by ideas pioneered in Europe, these clinics have opened over the past decade to serve the growing number of young people seeking hormonal medications to transition. Many patients and parents told The New York Times that the St. Louis team provided essential care, helping adolescents feel comfortable in their bodies for the first time. Some patients said they were lifted out of grave depression.

But as demand rose, more patients arrived with complex mental health issues. The clinic’s staff often grappled with how best to help, documents show, bringing into sharp relief a tension in thefield over whether some children’s gender distress is the root cause of their mental health problems, or possibly a transient consequence of them.

With its psychologists overbooked, the clinic relied on external therapists, some with little experience in gender issues, to evaluate the young patients’ readiness for hormonal medications. Doctors prescribed hormones to patients who had obtained such approvals, even adolescents whose medical histories raised red flags. Some of these patients later stopped identifying as transgender, and received little to no support from the clinic after doing so.

Unwanted outcomes and regrets happen in every branch of medicine, but several clinics around the world have reported challenges similar to those in St. Louis. Pediatric gender medicine is a nascent specialty, and few studies have tracked how patients fare in the long term, making it difficult for doctors to judge who is likely to benefit.

In several European countries, health officials have limited — but not banned — the treatments for young patients and have expanded mental health care while more data is collected. In the United States, health groups have endorsed what’s known as affirming care even as their peers in Europe have grown more cautious. And conservative lawmakers in more than 20 states have taken the draconian step of banning or severely restricting gender treatments for minors.

Civil rights groups are challenging the Missouri ban in a hearing this week, and Ms. Reed testified on Tuesday in favor of it, describing her allegations in detail.

Washington University created an oversight committee to carry out weekly reviews of the gender clinic’s operations. The school’s investigation claimed that none of the clinic’s 598 patients on hormonal medications reported “adverse physical reactions.” In a statement to The Times, the university said that it would not address specific allegations because of patient privacy, and that “physicians and staff have treated patients according to the existing standard of care.”

But doctors in St. Louis and elsewhere are wrestling with evolving standards and uncertain scientific evidence — all while facing intense political pressure and an adolescent mental health crisis.

An Affirming Approach

 

America’s first youth gender center opened in Boston, in 2007, after two clinicians — Dr. Norman Spack, an endocrinologist, and Laura Edwards-Leeper, a child psychologist — traveled to the Netherlands to observe a promising treatment for children with gender distress, known as dysphoria.

The Dutch doctors were prescribing drugs that stalled puberty in order to prevent the physical changes that often exacerbate dysphoria. The approach, they reasoned, would give the adolescents time to consider whether to proceed with estrogen or testosterone treatments later on.

Transgender children have high rates of anxiety, depression and suicide attempts. The Dutch found that for a specific group — adolescents with no severe psychiatric disorders who had experienced gender dysphoria since early childhood — their depression lessened after taking puberty blockers.

When Dr. Spack and Dr. Edwards-Leeper opened the Boston clinic, they hewed closely to the Dutch approach. In its first five years, the clinic treated just 70 patients.

Similar clinics opened around the country, diverging over time from the strict Dutch protocols into an affirming approach that prioritized a child’s inner sense of gender. It was unethical, some argued, to deny care to children with psychiatric problems when gender treatments could help resolve those issues.

In 2012, parents in St. Louis began lobbying leaders of the children’s hospital to set up an affirming clinic. The parents invited Dr. Spack to town to talk about his experience in Boston.

“In Missouri there were no knowledgeable doctors on this subject,” said Kim Hutton, a founder of the group, called TransParent. “It was left to the parents to try to figure it out.”

The clinic opened in 2017, led by Dr. Christopher Lewis, a pediatric endocrinologist, and Dr. Sarah Garwood, an adolescent medicine specialist, who had each attended TransParent meetings. They saw patients once a week on the second floor of the St. Louis Children’s Hospital, spending most days elsewhere in the sprawling complex.

When Ms. Reed arrived, in 2018, she was the clinic’s only full-time employee. Eventually, the clinic would have about nine staff members, most part-time.

Their patients were part of a striking generational change: Between 2017 and 2020, about 1.4 percent of 13- to 17-year-olds in the United States identified as transgender, nearly double the rate from a few years earlier.

It’s clear the St. Louis clinic benefited many adolescents: Eighteen patients and parents said that their experiences there were overwhelmingly positive, and they refuted Ms. Reed’s depiction of it. For example, her affidavit claimed that the clinic’s doctors did not inform parents or children of the serious side effects of puberty blockers and hormones. But emails show that Ms. Reed herself provided parents with fliers outlining possible risks.

Ms. Hutton’s son, who requested anonymity because of privacy concerns, is now in college, and said he was grateful he transitioned years earlier. “I have normal-people problems, which is all that I ever wanted,” he said.

Another patient, Chris, now 19, who also requested anonymity to protect his privacy, recalled Dr. Lewis patiently drawing diagrams on the paper sheet of his exam chair, explaining how testosterone would redistribute his body fat and permanently deepen his voice. Chris felt “drastically improved” after taking the hormone, he said, but was still distressed by his breasts. At 17, he went to a surgeon in Ohio for a mastectomy.

And Becky Hormuth, a teacher in St. Charles, Mo., praised the center’s doctors for their approach to her son’s mental health. The doctors diagnosed her 15-year-old with autism, she said, and connected him with a dietitian to help treat his eating disorder — before prescribing testosterone. Now, at 16, her son is “better than he’s ever been,” Ms. Hormuth said.

A family therapist in St. Louis, Katie Heiden-Rootes, said she had worked with or supervised the counseling of roughly 30 of the clinic’s patients and had never seen problems with their care.

“The biggest complaint I heard about the clinic was, ‘We can’t get in,’” Dr. Heiden-Rootes said.

The Red Flag List

When Ms. Reed, 43, began working at the clinic, she considered herself a fierce champion of the gender-affirming model. In her previous jobs — at Planned Parenthood, at an H.I.V. clinic and in the foster care system — she had also supported L.G.B.T.Q. young people. And her husband, a transgender man, had shown her how essential gender-affirming care could be.

Ms. Reed’s job at the clinic was akin to that of a social worker — collecting medical histories, triaging appointments and supporting patients in the hospital, at school and in court.

Her doubts about the affirming model arose in 2019, she said, after hearing from an upset patient who regretted their medical transition. She grew more concerned in 2020 as more new patients sought the clinic’s help, many with psychological problems exacerbated by the pandemic. She saw parallels with England’s youth gender clinic, known as the Tavistock, which was under investigation after employees complained about feeling pressure to approve children for puberty blockers as their wait-list swelled.

The St. Louis center relied heavily on outside therapists to vet patients, emails show. Doctors there prescribed hormones to patients who had identified as transgender for at least six months, had received a letter of support from a therapist and had parental consent.

Frustrated that the clinic had no system to keep track of patient outcomes, Ms. Reed and the clinic’s nurse, Karen Hamon, kept a private spreadsheet, which they called the “red flag list.” (Ms. Reed gave The Times a version of the spreadsheet without identifying information. Ms. Hamon and other clinic employees declined to comment for this article.)

The list eventually included 60 adolescents with complex psychiatric diagnoses, a shifting sense of gender or complicated family situations. One patient on testosterone stopped taking schizophrenia medication without consulting a doctor. Another patient had visual and olfactory hallucinations. Another had been in an inpatient psychiatric unit for five months.

On a different tab, they tallied 16 patients who they knew had detransitioned, meaning they had changed their gender identity or stopped hormone treatments.

One patient emailed the clinic, in January 2020, to say they had detransitioned and were seeking a voice coach for their masculinized voice. They also requested a referral for an autism screening, noting, “I have mentioned this before at appointments and over email, but it did not seem to go anywhere.”

In another email thread, the center’s staff discussed a patient who regretted a recent mastectomy. The patient had messaged their surgeon at Washington University twice about wanting a breast reconstruction, but had not received a reply.

The Times independently found another St. Louis patient who detransitioned, Alex, who posted on Reddit last year to “give a warning” about the clinic. (Alex shared medical records with The Times to corroborate her account.)

Alex arrived at the center in late 2017 at age 15, she said, after identifying as transgender for three years. She had been referred by a therapist who was treating her for bipolar disorder and anxiety.

Alex was prescribed testosterone, she said, after one appointment with Dr. Lewis. “There was no actual speaking to a psychiatrist or another therapist or even a case worker,” she wrote on Reddit.

After three years on the hormone, she realized she was nonbinary and told the clinic she was stopping her testosterone injections. The nurse was dismissive, she recalled, and said there was no need for any follow-ups.

Alex, now 21, does not exactly regret taking testosterone, she told The Times, because it helped her sort out her identity. But “overall, there was a major lack of care and consideration for me,” she said.

The number of people who detransition or discontinue gender treatments is not precisely known.

Small studies with differing definitions and methodologies have found rates ranging from 2 to 30 percent. In a new, unpublished survey of more than 700 young people who had medically transitioned, Canadian researchers found that 16 percent stopped taking hormones or tried to reverse their effects after five years. Survey responders reported a variety of reasons, including health concerns, a lack of social support and changes in gender identity.

‘Disastrously Overwhelmed’

Nearly 15 years after bringing the Dutch approach to America, Dr. Edwards-Leeper, the Boston psychologist, had grown alarmed by the rise in adolescents seeking gender treatments.

In a November 2021 Washington Post opinion piece, Dr. Edwards-Leeper warned that American gender clinics were prescribing hormones to some children who needed mental health support first.

“We may be harming some of the young people we strive to support — people who may not be prepared for the gender transitions they are being rushed into,” she wrote with Erica Anderson, the former president of the U.S. Professional Association for Transgender Health and a transgender woman.

In St. Louis, Dr. Andrea Giedinghagen, the clinic’s psychiatrist, emailed the essay to her colleagues. “This basically encapsulates the (very complex, nuanced) views that the child and adolescent psychiatrists I know at various gender centers hold,” Dr. Giedinghagen wrote.

The head of the clinic, Dr. Lewis, responded, adding a university administrator to the thread. “I DO think our clinic, and transgender care at large, exhibits some of the concerns mentioned,” he wrote, including being “disastrously overwhelmed.”

But, he added, “No matter the approach there will be a percentage of patients that should have been started that weren’t and vice versa.”

By the end of 2021, emails show, the clinic was getting calls from four or five new patients every day — a sharp rise from 2018, when it saw that many over the course of a month. And, according to an internal presentation from 2021, 73 percent of new patients were identified as girls at birth. Gender clinics in Western Europe, Canada and the United States have reported a similarly disproportionate sex skew that has bewildered clinicians.

Other parts of the St. Louis hospital were also seeing more transgender patients. In August and September of 2022, Ms. Reed and Ms. Hamon, the clinic’s nurse, conducted a half-dozen training sessions with the emergency department to explain their work at the gender clinic. At the trainings, E.R. staff shared concerns about their own experiences with their young transgender patients, which Ms. Hamon later relayed to her team and university administrators.

The E.R. staff, she wrote in an email, had been seeing more transgender adolescents experiencing mental health crises, “to the point where they said they at least have one TG patient per shift.”

“They aren’t sure why patients aren’t required to continue in counseling if they are continuing hormones,” Ms. Hamon added. And they were concerned that “no one is ever told no.”

As similar mental health issues bubbled up at clinics worldwide, the international professional association for transgender medicine tried to address them by publishing specific guidelines for adolescents for the first time. The new “standards of care,” released in September, said that adolescents should question their gender for “several years” and undergo rigorous mental health evaluations before starting hormonal drugs.

Dr. Lewis worried that his clinic would not be able to adjust to the new standards, known as the S.O.C.

“Right now I have no idea how to meet what would be the most intensive interpretations of the SOC,” Dr. Lewis texted Ms. Hamon. (She took a screenshot of the message and sent it to Ms. Reed.) He suggested meeting with staff members to discuss how they could abide by the new guidelines.

In its statement, the university said that the clinic prioritized mental health care and that licensed external therapists “make a vital contribution to that effort.” It also said that “patients have ongoing relationships with mental health providers.”

Some former staff members said the clinic was doing the best it could for patients with complex psychiatric histories. Cate Hensley, a social worker who interned at the clinic from 2020 to 2021, said that the team had a weekly meeting to discuss such cases.

She also said that U.S. hospitals and health insurers invested far too little in mental health, putting extra pressure on doctors and hurting patients.

“This center is providing ethical care in an unethical system,” Mx. Hensley said.

Political Agendas

By the end of last year, Republican lawmakers in Missouri had turned gender care for minors into a rallying cry. And Ms. Reed, formerly a staunch defender of the affirming model, had become openly skeptical of it, raising concerns in internal emails and in meetings despite warnings from higher-ups.

Her performance review in 2022 stated that she “responds poorly to direction from management with defensiveness and hostility.” In November, she left the gender clinic and started a new role at the university coordinating pediatric cancer research.

Ms. Hamon raised doubts as well, according to text messages and emails provided by Ms. Reed. In January of this year, she emailed an administrator to explain why she did not want a management role at the center.

“You know I have struggled with ethical dilemmas about how we do things for quite some time,” Ms. Hamon wrote.

That month, Ms. Reed obtained a prominent parental rights lawyer, Vernadette Broyles. Shortly thereafter, she filed her complaint with the state and publicized her allegations in an essay in The Free Press. Ms. Broyles is a vocal proponent of gender treatment bans for minors and has said the “transgender movement” poses an “existential threat to our culture.”

Ms. Reed said that she supported the rights of transgender adults like her husband, and that Ms. Broyles was the only lawyer who would take her case pro bono. Still, Ms. Reed does not deny that her views have hardened and become political: “I support a national moratorium on the medicalization of kids,” she said.

One parent said that, perhaps in pursuit of this political aim, Ms. Reed had misrepresented her child’s experience.

Ms. Reed’s affidavit describes a patient whose liver was damaged after taking bicalutamide, a drug that blocks testosterone. It makes a specific claim about what a parent had written to the child’s doctors: “The parent said they were not the type to sue, but ‘this could be a huge P.R. problem for you.’”

The parent, Heidi, a data scientist in the St. Louis area who requested anonymity because of privacy concerns, said she was stunned to read this “twisted” description of her teenage daughter’s case.

Heidi’s daughter indeed had liver damage, a rare side effect of bicalutamide. But she had been taking the drug for a year, records show, and had a complicated medical history. She was immunocompromised, and experienced liver problems only after getting Covid and taking another drug with possible liver side effects.

In a message to doctors that was shared with The Times, Heidi actually wrote, “In our world, it’s like a P.R. nightmare” — referring to tensions in her family about the gender treatments. The message did not mention anything about suing the clinic. To the contrary, it said: “We don’t regret any decision.”

Ms. Reed said that she learned about the case from Ms. Hamon, who helped compile examples for the affidavit, and that she regretted citing the case when she had not seen the medical record herself.

“My daughter’s situation was exploited,” Heidi said, noting that the hospital told her that her records would be shared with the state.

Missouri’s ban of gender care for minors will begin on Aug. 28 unless the hearing this week results in a preliminary injunction. If the law goes into effect, the clinic will not be allowed to enroll new patients.

Some families are not waiting for the legal proceedings to play out. Jennifer Harris Dault, a Mennonite pastor, moved her family from St. Louis to New York in July to ensure that her 8-year-old transgender daughter could get gender treatments when she nears puberty.

“The more I see coming out of Missouri the more I know we made the decision that was right for us,” she said.

The attorney general’s investigation into the clinic’s practices is ongoing, as is an inquiry by Senator Josh Hawley, a Republican. While several families said they blamed Ms. Reed for the political fallout, others said the university bears responsibility, too.

For decades, Dr. John Daniels was the sole endocrinologist in St. Louis prescribing hormones to transgender adults. He did so, he said, because he saw profound benefits in his patients and because, as a gay man, he appreciated the diversity of the human experience.

When Ms. Reed’s allegations came out, he was shocked, and emailed her to ask if she had ever reported concerns to Washington University. She replied that she had, but was ignored.

“I hate that the politicians have gotten involved with this, but I do have great concerns about how adolescents and preadolescents are being treated,” Dr. Daniels wrote. “That the higher-ups at W.U. didn’t take you seriously is now on them.”

Kirsten Noyes contributed research.

 

 

Edited October 11, 2024 by Analytics

[ZealouslyStriving]

2 hours ago, Calm said:

But if the issue is electively cutting off healthy body parts, then why aren’t you talking about it as one surgery of the collection of surgeries you find inappropriate as elective removal of healthy body parts…at least enough to say “yes, I apply the same standards to it” as in we need to look at comorbidities, etc associated with it in making decisions about the appropriateness of such surgery.

It qualifies as electively removing healthy body parts, does it not?

If you don’t include circumcision in this discussion or do not apply the same standards to it for some reason, it would appear that it is not a discussion focused on the issue of cutting off healthy body parts, but something else, something more than just the removal of healthy body parts. 

False equivalent.

A fleck of skin at the end of a penis is hardly the same as an entire functioning penis.

 

[Rain]

4 hours ago, Rain said:

CFR that "the crowd" is saying "anything" is ok. From my reading, even the most vocal advocates of child and parent choice do not feel "anything" is ok, let alone sacrosanct.

 

@ZealouslyStriving this is an actual CFR.  Please provide the reference or withdraw your statement.

[longview]

3 hours ago, Calm said:

Quote

Are the folks trying to inject circumcision into this discussion opposed to circumcision[gender affirming care?]?  It seems like an attempt at Whataboutism:

Not really.  It appears to me a major part of your argument is founded on being opposed to elective removal of healthy body parts.  That is why you included the discussion on the woman who wants her healthy legs to be remove or paralyzed, I thought.

Am I correct in thinking that one of your major concerns with surgical transitioning is the elective removal of healthy body parts?  If not, why did you bring up the example of the woman and ask if someone was okay with removing of her limb (or whatever the specifics of your question was)?

How interesting that you are carefully skirting around an important question:

3 hours ago, smac97 said:

Do you you see any distinctions between male circumcision and a penectomy?  Or a mastectomy? 

Please answer this question!

[Kenngo1969]

11 hours ago, longview said:

For the most part, both. If the person happens to be a faithful member of the Church, hopefully that person will strive to live the Gospel and being chaste and walk with God in all circumstances. Trusting that God will make things right in this life or the next world. In the end there will be incredible joy unimaginable.

+1. 

[Calm]

7 hours ago, longview said:

How interesting that you are carefully skirting around an important question:

Please answer this question!

I am not the one making the argument that surgery should not be allowed because of removal of healthy body parts. Smac was.  Why would I be the one to defend a position I have never claimed or promoted?

I have made the argument elective surgery for minors should not be allowed except in extreme cases because I don’t believe the medical establishment provides sufficient mental health care in many, probably even most cases, especially for minors basing this on my own personal experience in this area over several decades and two countries for myself and many others plus my research into the quality of mental health care for minors in this country, so feel free to ask me to defend this.  I have also stated my preference for waiting until someone is 25 so that they will more likely have a realistic emotional idea of longterm ramifications and the logical ability to weigh the cost, though it will still be hard to truly imagine what 60 years of dealing with medical issues will be like.  I know when I was younger I dismissed a lot of consequences by thinking the medical establishment would have the issues solved by the time I needed to deal with it…yeah, that didn’t actually happen.  I am now having to have procedures done on my back and have a lot of doubt dementia will be cured by the time it hits me if I take after my mother (really hoping I take after my father).  I am praying it will at least happen for my daughter.

Edited October 11, 2024 by Calm

[Calm]

3 hours ago, ZealouslyStriving said:

False equivalent.

A fleck of skin at the end of a penis is hardly the same as an entire functioning penis.

 

Then there needs to be included a standard of how much healthy body part can be cut off and reasons for drawing the line provided.

Still it is more than just a fleck of skin.

https://pubmed.ncbi.nlm.nih.gov/23374102/

Quote

Today some studies on the effect of circumcision on sexual function are available. However they vary widely in outcome. The present study shows in a large cohort of men, based on self-assessment, that the foreskin has erogenous sensitivity. It is shown that the foreskin is more sensitive than the uncircumcised glans mucosa, which means that after circumcision genital sensitivity is lost. In the debate on clitoral surgery the proven loss of sensitivity has been the strongest argument to change medical practice. In the present study there is strong evidence on the erogenous sensitivity of the foreskin. This knowledge hopefully can help doctors and patients in their decision on circumcision for non-medical reason.

 

Edited October 11, 2024 by Calm

[longview]

23 minutes ago, Calm said:

I am not the one making the argument that surgery should not be allowed because of removal of healthy body parts. Smac was.  Why would I be the one to defend a position I have never claimed or promoted?

It is a simple question. Just answer it. Are you trying to gaslight the board?

[Malc]

2 minutes ago, Calm said:

Then there needs to be included a standard of how much healthy body part can be cut off and reasons for drawing the line provided.

Calm - I was about to - pun intended - ask where ZS thought the cutoff point should be.

[california boy]

3 hours ago, ZealouslyStriving said:

False equivalent.

A fleck of skin at the end of a penis is hardly the same as an entire functioning penis.

 

So now we are just discussing how much of the penis should be cut off,  Interesting....

[Calm]

4 hours ago, longview said:

Are you trying to gaslight the board?

Never.  And that is quite an offensive accusation.  I have no doubt many sins, but lying isn’t one of them.  I don’t claim high morality on this, it has always made me physically ill (as in nauseated) to do so, even telling the so called white lies to my grandparents that I was doing fine because I didn’t want them to worry or the lectures of what I needed when they were clueless about my situation.  I just find it easier not to lie.  I also find accusations of dishonesty one of the nastier accusations, probably for the same reason lying makes me feel ill, there is just an inherent wrongness about it.  If you are ever inclined to think I am lying, the better guess is one of us has misunderstood something.

Apparently you don’t understand my reasoning here.  The quality of an argument doesn’t depend on whether I agree with the outcome, but how it is structured and supported.  I see Smac’s argument as missing some steps here, which opens it to an accusation of double standard.  He can deal with the gaps or just deny that it is a double standard, but if he ignores the gaps, it weakens his position dramatically.

Because of the gaps, I am not sure whether I support his position or not, though it appears we mostly agree since my position is elective surgery in general should be delayed till adulthood except in extreme cases, though my guess is we might differ significantly on what is extreme.  And I am more prone to leave it in doctors’ hands because I think one of the reasons medicine is so political these days is because lawmakers stepped in to make these kinds of decisions in the past.  Plus I find there are too many lawmakers woefully uninformed about it.  Not saying doctors don’t err because my whole position is based on the error of doctors, just don’t see the process getting better because lawmakers got involved.  I could support laws that require educational materials such as suggested by California boy iirc, as long as it was doctors putting the materials together and not lawmakers.

Btw, I am pro male circumcision at this point based on medical research with the benefits outweighing the negatives in my view.  Pogi (I think it was him) had persuaded me to change my mind, but newer research changed me back.   
 

https://www.nature.com/articles/s41443-020-00354-y

 

Edited October 11, 2024 by Calm

[Rain]

21 minutes ago, Calm said:

Never.  And that is quite an offensive accusation.

Apparently you don’t understand my reasoning here.  The quality of an argument doesn’t depend on whether I agree with the outcome, but how it is structured and supported.  I see Smac’s argument as missing some steps here, which opens it to an accusation of double standard.  He can deal with the gaps or just deny that it is a double standard, but if he ignores the gaps, it weakens his position dramatically.

Because of the gaps, I am not sure whether I support his position or not, though it appears we mostly agree since my position is elective surgery in general should be delayed till adulthood except in extreme cases, though my guess is we might differ significantly on what is extreme.  And I am more prone to leave it in doctors’ hands because I think one of the reasons medicine is so political these days is because lawmakers stepped in to make these kinds of decisions in the past.  Plus I find there are too many lawmakers woefully uninformed about it.  Not saying doctors don’t err because my whole position is based on the error of doctors, just don’t see the process getting better because lawmakers got involved.  I could support laws that require educational materials such as suggested by California boy iirc, as long as it was doctors putting the materials together and not lawmakers.

Btw, I am pro male circumcision at this point based on medical research with the benefits outweighing the negatives in my view.  Pongi (I think it was him) had persuaded me to change my mind, but newer research changed me back.   
 

https://www.nature.com/articles/s41443-020-00354-y

 

Pogi

[Calm]

3 hours ago, Rain said:

Pogi

Yeah, I keep blowing his name because of it’s similarity to Pogo and Bongo for some reason.

[bluebell]

8 hours ago, Calm said:

Never.  And that is quite an offensive accusation.  I have no doubt many sins, but lying isn’t one of them.  I don’t claim high morality on this, it has always made me physically ill (as in nauseated) to do so, even telling the so called white lies to my grandparents that I was doing fine because I didn’t want them to worry or the lectures of what I needed when they were clueless about my situation.  I just find it easier not to lie.  I also find accusations of dishonesty one of the nastier accusations, probably for the same reason lying makes me feel ill, there is just an inherent wrongness about it.  If you are ever inclined to think I am lying, the better guess is one of us has misunderstood something.

Apparently you don’t understand my reasoning here.  The quality of an argument doesn’t depend on whether I agree with the outcome, but how it is structured and supported.  I see Smac’s argument as missing some steps here, which opens it to an accusation of double standard.  He can deal with the gaps or just deny that it is a double standard, but if he ignores the gaps, it weakens his position dramatically.

Because of the gaps, I am not sure whether I support his position or not, though it appears we mostly agree since my position is elective surgery in general should be delayed till adulthood except in extreme cases, though my guess is we might differ significantly on what is extreme.  And I am more prone to leave it in doctors’ hands because I think one of the reasons medicine is so political these days is because lawmakers stepped in to make these kinds of decisions in the past.  Plus I find there are too many lawmakers woefully uninformed about it.  Not saying doctors don’t err because my whole position is based on the error of doctors, just don’t see the process getting better because lawmakers got involved.  I could support laws that require educational materials such as suggested by California boy iirc, as long as it was doctors putting the materials together and not lawmakers.

Btw, I am pro male circumcision at this point based on medical research with the benefits outweighing the negatives in my view.  Pogi (I think it was him) had persuaded me to change my mind, but newer research changed me back.   
 

https://www.nature.com/articles/s41443-020-00354-y

 

For a few years my mom was a home health nurse and she would talk about some of her elderly male patients who ended up needing to be circumcised as seniors due to frequent infections (she would not talk about the people specifically, just the medical stuff).  The whole process, from the infections, to the healing afterward for someone that age, made me pro circumcision.  

I do think that smac was meaning whole body parts and not pieces of skin when he made that point, but he could have clarified that at the very beginning and this side bar could have stopped there.

[Calm]

58 minutes ago, bluebell said:

I do think that smac was meaning whole body parts and not pieces of skin when he made that point

The skin is the largest organ of the body.  

[Tacenda]

2 hours ago, bluebell said:

For a few years my mom was a home health nurse and she would talk about some of her elderly male patients who ended up needing to be circumcised as seniors due to frequent infections (she would not talk about the people specifically, just the medical stuff).  The whole process, from the infections, to the healing afterward for someone that age, made me pro circumcision.  

I do think that smac was meaning whole body parts and not pieces of skin when he made that point, but he could have clarified that at the very beginning and this side bar could have stopped there.

My daughter chose not to circumcise my grandsons, and I sometimes wonder if that's difficult for social reasons being different than their friends, if showering at school etc. But now I see the problem with possible infections I worry about that now. Awhile back I watched a talk show about men that say they shouldn't have been circumcised and one of the reasons was the fact that it took away feeling, during sex. But maybe TMI, but that's one thing to counterbalance I guess. 

[smac97]

15 hours ago, Analytics said:

Quote

The bona fides of the author are noteworthy to me.

Surely you aren’t quoting this article because as a general rule you especially value the opinion of queer women who are more than liberal Bernie Sanders and are married to transmen, are you?

First, as to matters requiring qualifications, experience, competency, etc., I could not care less about the sexual orientation or gender of the person speaking on the subject.  Instead, I look to the person's qualifications, experience, competency, etc.  

Second, the author's "bona fides" which I found most noteworthy pertain to her percipient experience working at The Washington University School of Medicine Division of Infectious Diseases and, later, at The Washington University Transgender Center at St. Louis Children’s Hospital.  The article has very little to say about the author being "queer," or woman, or about her political bent, or about her marriage.

Third, although the author provides her opinions, the primary value of the article centers on reported observations about what she saw and experienced in the trans clinic.  Again, her bona fides arise from her being a percipient witness.

Fourth, the author's sexual orientation and marriage to a "transman" is a secondary or tertiary consideration, but still one worth some attention.  Some folks are so enmeshed in ideological devotion that they preemptively adjudicate a person's experience based on that person's "identity."  For example, Latter-day Saints can sometimes disregard, out-of-hand, fair points made by anti-Mormons, whereas they might be more receptive to those same points if made by someone not seen as an ideological opponent.  So candid assessments of Joseph Smith in Richard L. Bushman's Rough Stone Rolling can be seen as having some added measure of credibility because its author is both an excellent historian and a faithful Latter-day Saint (not an ideological opponent).

So perhaps people who are ideologically predisposed to support medical treatments involving electively removing healthy body parts of children and electively sterilizing children just might see Jamie Reed's candid assessment of medical care of minors seeking "trans" care as having added measures of credibility because she is both a percipient witness of what is going on and a queer woman married to a transman (not an ideological opponent).

Fifth, are you disputing the contents of Jamie Reed's article on ideological grounds?  Because her statements contravene or weaken your ideological support for medical treatments involving electively removing healthy body parts of children and electively sterilizing children?

15 hours ago, Analytics said:

Rather, you are quoting this article because it agrees with your preconceptions, right?

I am quoting this article primarily because she is a percipient witness.

15 hours ago, Analytics said:

If she didn’t agree with you, her bona fides would be the basis of her biases and not reasons to especially value her opinion, right?

No.

Again, her "bona fides" pertain to her being a percipient witness to the goings-on at The Washington University Transgender Center at St. Louis Children’s Hospital.

Similarly, I have looked at the bona fides of David Bell as pertaining to the Tavistock Clinic in the UK.  See, e.g., this 2021 article:

Tavistock trust whistleblower David Bell: ‘I believed I was doing the right thing’

Quote

To talk to David Bell is to have some small sense of what it might be like to be his patient. At 70, his energy puts mine to shame. He cycles everywhere. His diary is full. I’ve rarely interviewed someone so engaged (there are days when he emails me several times, each message more exacting than the last). But ask him a question and he’s unlikely to rush in. Certainty is not a given. His open-mindedness belongs to someone far younger. Above all, he is so calm: a reassuring presence. There are times during our conversation when it’s hard to believe we’re discussing experiences that must have caused him so much anxiety and even, at moments, some fear.

Bell, a distinguished psychiatrist and practising psychoanalyst, is the doctor who in 2018 wrote a controversial report about the activities of the gender identity development service (GIDS), a clinic at the Tavistock and Portman NHS foundation trust in north London, where he worked in adult services from 1995 until his retirement earlier this year.

Again, as to matters requiring qualifications, experience, competency, etc., I could not care less about the sexual orientation or gender of the person speaking on the subject.  Instead, I look to the person's qualifications, experience, competency, etc.  

Here, Dr. Bell's bona fides arise from him being "a distinguished psychiatrist and practising psychoanalyst" and having worked at the Tavistock Clinic from 1995 to 2021.

Quote

GIDS, the only clinic of its kind in England, specialises in treating children with gender identity issues and in recent months has been in the news even more than usual. Last December, a judgment by the high court ruled that those under the age of 16 were unlikely to be mature enough to give informed consent to the prescription of puberty blockers (such drugs delay the development of secondary sex characteristics in patients, in theory enabling children more easily to transition into their desired gender identity as an adult).

Informed consent.  It's an important topic that I have raised several times (most recently in a bullet list in this thread).

Quote

This ruling, the result of a judicial review brought by 23-year-old Keira Bell – born female, she was prescribed blockers by GIDS at 16 and now regrets her transition – has effectively curtailed medical intervention for children with gender dysphoria. (The Tavistock is to appeal; the case will be heard in June. David Bell will be what is technically called an intervenor in the appeal, which means he can give evidence.)

Dr. Bell is a percipient witness to the goings-on at the Tavistock Clinic.  I think we should hear what he has to say.

I would hope that you would not preemptively dispute or ignore his testimony on ideological grounds, even if his statements contravene or weaken your ideological support for medical treatments involving electively removing healthy body parts of children and electively sterilizing children.

Quote

Bell’s report anticipated the concerns of the high court and he feels vindicated by its judgment. “It was jaw-dropping,” he says. “Because it was very strong.” As he read it, he was struck by details that have not been widely reported, particularly those involving a lack of data, a problem he had raised himself (GIDS was unable to produce for the court any data relating to outcomes and effects, whether desirable or adverse, in children who had been prescribed puberty blockers; nor could it provide details of the number and ages of children who had been given them).

The Tavistock Clinic "was unable to produce for the court any data relating to outcomes and effects, whether desirable or adverse, in children who had been prescribed puberty blockers; nor could it provide details of the number and ages of children who had been given them."

Wow.

Quote

But the experience was painful, too: “I felt concerned that we’d moved away from the values [of care] the trust has embodied for so long.” He is astonished the judgment seems to have had so little effect on the organisation of GIDS. “Ordinarily, heads would roll,” he says. “The management structure has changed slightly, but it feels like window-dressing.”

But whatever the court’s verdict, it cannot change the fact that the organisation to which Bell devoted the greater part of his working life did not respect his rights as a whistleblower. Nor has it taken the heat out of the debate about the medical treatment of trans children – if anything, the discourse has only grown more entrenched – which is why he’s talking to me now. This is the first time he has spoken in detail about his experiences: about how he came to write his report and the grave consequences that doing so had for him. His retirement means that the threats of disciplinary action against him are over. He is free, at last, to say what he likes.

Writing the report was, he says, a matter of conscience. In 2018, 10 GIDS staff brought their worries to him unsolicited, a figure he estimates to be around a third of those then working there. He had no choice but to act and would do the same again. Nevertheless, it was not easy. Far from being grateful to him for alerting it to a potentially dangerous situation, the trust’s position appeared defensive – having read the correspondence involved, perhaps aggressively so – almost from the start. It tried to silence him and instituted proceedings against him. Was he frightened? Yes and no. “I believed I was doing the right thing,” he says. “I never doubted that, and most of my colleagues in the adult department supported me, so when I went up to my floor at the Tavistock, I could be oblivious and get on with my work. The real betrayal wasn’t of me personally, but of the trust’s duty to whistleblowers and to its wider mission [since 1920, the Tavistock has specialised in talking cures]. But the thing that enables you to sleep at night is a good lawyer.” To pay for this lawyer, he launched two crowdfunding appeals.

How, exactly, did the trust attempt to silence him? The trust told the Observer that it is proud of the GIDS service, which is committed to providing high-quality support and care for young people experiencing issues with gender dysphoria, and that the claims made by Dr Bell are historical and were dealt with following proper processes at the time. It vigorously denies that any steps were taken against Bell for being a whistleblower. It says that it has a duty to safeguard its staff, who have faced intense, personalised and upsetting harassment, and has taken a series of actions, following proper processes, to do this.

By Bell’s telling, its approach was at once Kafkaesque and cack-handed. In the months after he delivered his report, a book to which he had written an introduction was removed from the Tavistock’s library. When he spoke at a conference about de-transition in Manchester, a member of GIDS’ staff travelled there, he says to spy on him. “They wrote it up very accurately,” he says, with a laugh. Finally, he was told that he was not allowed to write about, or to talk in public about, anything that wasn’t directly connected to his NHS employment, “which sounded odd to me… was it the case that if I was going to write a paper about the psychology of King Lear, I’d have to ask permission?” (As his lawyer informed him, this was against the terms of his contract.)

The story begins in February 2018, with a knock on Bell’s office door. “I was often the person people came to when they had problems,” he says. Having worked as a consultant at the Tavistock for more than 25 years, he was one of its most senior doctors: for 10 years, he was in charge of its scientific programme; in 2018, he was also an elected staff governor of the trust, for the second time. Of the 10 GIDS staff who would talk to him over the course of the next seven months, only the first saw Bell at the Tavistock; the others, who spoke of intimidation, worried about being seen. What did he make of what they told him? “My blood ran cold. Their concerns were similar, but not in a choreographed way. One or two were severely troubled.”

Among these concerns were the fact that children attending GIDS often seemed to be rehearsed and sometimes did not share their parents’ sense of urgency; that senior staff spoke of “straightforward cases” in terms of children who were to be put on puberty blockers (no case of gender dysphoria, notes Bell, can be said to be straightforward); that some were recommended for treatment after just two appointments and seen only infrequently thereafter; some felt that GIDS employed too many inexperienced (and inexpensive) psychologists; that clinicians who’d spoken of homophobia in the unit were told they had “personal issues”. One told Bell that a child as young as eight had been referred to an endocrinologist for treatment. “I could not go on like this… I could not live with myself given the poor treatment the children were obtaining,” said another.

• "{T}hreats of disciplinary action" against a medical practitioner if he speaks about what he experienced at the Tavistock Clinic.
• "Far from being grateful to him for alerting it to a potentially dangerous situation, the trust’s position appeared defensive – having read the correspondence involved, perhaps aggressively so – almost from the start.  It tried to silence him and instituted proceedings against him."
• "Finally, he was told that he was not allowed to write about, or to talk in public about, anything that wasn’t directly connected to his NHS employment."
• "Of the 10 GIDS staff who would talk to him over the course of the next seven months, only the first saw Bell at the Tavistock; the others, who spoke of intimidation, worried about being seen. What did he make of what they told him? 'My blood ran cold. Their concerns were similar, but not in a choreographed way. One or two were severely troubled.'"
• "{C}hildren attending GIDS often seemed to be rehearsed and sometimes did not share their parents’ sense of urgency."
• "One told Bell that a child as young as eight had been referred to an endocrinologist for treatment."

Ideological/sociopolitical influences/pressures on medical care.  

Compromised assessments of the best interests of the child. 

These are important topics that I have raised several times (most recently in a bullet list in this thread).

Dr. Bell's statements and experiences are germane.

Quote

Was he surprised? How much did he know about GIDS before these conversations? (The clinic, which was established in 1989, had grown hugely during his time. In 2009, it saw 80 patients. By 2019, this figure had risen to 2,700.) “That’s a good question. It started as a small service, then it became nationally funded; a contract with NHS England meant a guaranteed income. It was peculiar. You could see that everyone knew about it and yet no one wanted to know about it. In the adult department, there was a sense that we didn’t want to find out what went on there, because we might not have liked it if we did.”

Bell wondered what he should do. “In July, I met with hospital management. I told them I would write a report. They said: OK. While I was writing it, I contacted GIDS. I needed to know some basic stuff: the number of patients they’d seen; their gender; what psychiatric problems they may have had.” He received no answers. “I then got a rather unpleasant letter from Paul Jenkins, the trust’s chief executive. It said that GIDS was very busy and that its staff were not obliged to answer me.” Was it that GIDS didn’t have the data or that it didn’t want Bell to have it? “Both.”

"Was it that GIDS didn’t have the data {the number of patients they’d seen; their gender; what psychiatric problems they may have had} or that it didn’t want Bell to have it? 'Both.'"

Wow.

Quote

In September, Bell sent his report to Jenkins and to Paul Burstow, the chairman of the board. For unspecified legal reasons, he says, they forbade him to send it to the council of governors, which oversees the board. “That was when I got myself a lawyer,” says Bell. His lawyer told him that, on the contrary, a failure to send it out might make him culpable in the event of any future legal case taken against the trust. When he did so, however, he received what felt like a “very hostile and threatening” note from Burstow. Nevertheless, the report was discussed at the next council, where it was agreed that a review of GIDS would be led by Dinesh Sinha, the trust’s medical director. In spite of this, in November 2018, Bell received two letters threatening disciplinary action. One of the grounds was “bullying”. He was not told whom he had bullied. He was also asked to agree not to speak any further to Sonia Appleby, the trust’s director of child safeguarding. (Appleby is bringing a whistleblowing claim against the trust in which she alleges that when she made “protected disclosures” regarding concerns raised by GIDS staff over patient safety, she was subjected to detriments.)

While Sinha’s review was taking place, Bell asked for its terms of reference. He wanted to ensure that those who’d talked to him could speak to the review safely, that their anonymity would be protected. He says he got no response. Bell wrote to staff at GIDS, reminding them of their right, as NHS workers, to speak confidentially. At this point, he says, the trust “went ballistic… they interfered with my emails so I couldn’t write to them again”. The trust’s review delivered its report in February 2019. Initially, Bell was not allowed to see it. He was then given 30 minutes to read its 70 pages (it was later leaked to him in full). “There was still no data. It mentioned intimidation, but no action was [to be] taken. However, it did acknowledge the inappropriate involvement of trans ideology groups in the work of the service.” The report was approved by the board and the council of governors, although one consultant psychotherapist, Marcus Evans, accused the trust of having an “overvalued belief” in GIDS expertise and resigned. Soon after this, Bell’s report was leaked to the press. “That disturbed me, until I read [the article],” he says. “The reporting was accurate. I started to think it was a good thing.” He says the trust began to suggest that Bell was unqualified to write such a report and to suggest that the cases in it were hypothetical. (They were not.)

In early 2020, procedures were set up for disciplinary action to be taken against Bell. “All the grounds were in connection with my activities as a whistleblower,” he says. In the meantime, Bell announced that he would retire, as he’d always planned to, in June 2020. But then the pandemic hit; wanting to see his unit through it, he decided to delay his departure until January 2021. The trust attempted more than once to set a date for the hearing, but these were always dropped. Bell felt all this was just for show.

His retirement was only weeks away.

"Bell received two letters threatening disciplinary action. One of the grounds was 'bullying'. He was not told whom he had bullied."

"In early 2020, procedures were set up for disciplinary action to be taken against Bell. 'All the grounds were in connection with my activities as a whistleblower.'"

Ideological/sociopolitical influences/pressures on medical care.  

Compromised assessments of the best interests of the child. 

These are important topics that I have raised several times (most recently in a bullet list in this thread).

Dr. Bell's statements and experiences are germane.

Quote

Last January, he retired as planned, only a month after the Keira Bell judgment. He had long believed a case would be brought against the trust, though he thought the most likely scenario was that a former patient would sue for damages (Keira Bell instigated a judicial review). “It was inevitable,” he says. “I warned the trust of this.” But the Keira Bell judgment has done little to alleviate his concerns. Whatever the outcome of the appeal, he believes more questions must be asked, particularly about the rise in the number of girls presenting at the clinic (three-quarters of patients are now girls; the gender balance used to be closer to 50:50). “We do not know why this is happening.” He worries that too much emphasis is placed on gender and not enough on sexuality – “the children are often gay” – and he continues to be anxious about co-morbidities such as anorexia, autism and history of trauma in its patients. “Some of the children are depressed. It’s said that it’s their gender that is the cause of this, but how do we know? And why don’t we try to treat that first?”

"'Some of the children are depressed. It’s said that it’s their gender that is the cause of this, but how do we know? And why don’t we try to treat that first?'"

Comorbidities.  It's an important topic that I have raised several times (most recently in a bullet list in this thread).

Quote

Bell is not against puberty blockers per se – “a doctor should never say never” – but he believes that halting puberty only makes it more frightening to the child: “The child will never want to come off the hormones and 98% do now stay on them. This could be a dangerous collusion on the part of the doctor. The body is not a video machine. You can’t just press a pause button. You have to ask what it really means to stop puberty.” It should be possible, he believes, to manage the distress of a child who is suffering gender dysphoria in a less interventionist way, until he or she is an adult and can make a decision: “Consent is the issue here, nothing else.” He does not doubt that some patients will want, and need, to transition in the future. But, he says, not all children with gender dysphoria are trans. The two have been elided. More work needs to be done locally. “Gender dysphoria clinics should be part of child and adolescent mental health services (CAMHS) and available nationwide,” he says. “At the moment, children who are suffering extreme distress in relation to their bodies are sent to the Tavistock and the problem then goes away at local level, where psychotherapy services are on their knees.”

When he appeared on Channel 4 News earlier this year, Bell was asked if he feared being on the wrong side of history. “I’ve often thought about that question,” he says. “It’s a good one. Psychiatry has a sad past. Homosexual men were given behavioural therapies and so on. But history isn’t always right. What matters is the truth. I hate the weaponisation of victimhood, the fact that the fear of being seen to be transphobic now overrides everything.” The current campaign to ban so-called gay conversion therapy is, he believes, likely to become a Trojan horse for trans activists who will use it to put pressure on any clinician who does not immediately affirm a young person’s statement about their identity, decrying this, too, as a form of “conversion”. For Bell, the prospect of not being able to talk openly about such things is a tyranny: just another form of repression. “This is about light and air,” he says. “It’s about free thinking, the kind that will result in better outcomes for all young people, whether transgender or not.”

• "'The child will never want to come off the hormones and 98% do now stay on them. This could be a dangerous collusion on the part of the doctor.'"
• "It should be possible, he believes, to manage the distress of a child who is suffering gender dysphoria in a less interventionist way, until he or she is an adult and can make a decision.  'Consent is the issue here, nothing else.'"
• "He does not doubt that some patients will want, and need, to transition in the future. But, he says, not all children with gender dysphoria are trans. The two have been elided."
• "{C}hildren who are suffering extreme distress in relation to their bodies are sent to the Tavistock and the problem then goes away at local level, where psychotherapy services are on their knees."
• “'They think this is to do with being liberal, rather than with concerns about the care of children. Mermaids and Stonewall [the charities for trans children and LGBTQ+ rights] have made people afraid even of listening to another view.'"
• "'I hate the weaponisation of victimhood, the fact that the fear of being seen to be transphobic now overrides everything.'"
• "The current campaign to ban so-called gay conversion therapy is {} likely to become a Trojan horse for trans activists who will use it to put pressure on any clinician who does not immediately affirm a young person’s statement about their identity, decrying this, too, as a form of 'conversion'."
• "'This is about light and air.  It’s about free thinking, the kind that will result in better outcomes for all young people, whether transgender or not.'"

Informed consent. 

Compromised assessments of the best interests of the child. 

Ideological/sociopolitical influences/pressures on medical care. 

These are topics that I have raised several times (most recently in a bullet list in this thread).

Thanks,

-Smac

Edited October 11, 2024 by smac97

[smac97]

2 hours ago, bluebell said:

For a few years my mom was a home health nurse and she would talk about some of her elderly male patients who ended up needing to be circumcised as seniors due to frequent infections (she would not talk about the people specifically, just the medical stuff).  The whole process, from the infections, to the healing afterward for someone that age, made me pro circumcision.  

I do think that smac was meaning whole body parts and not pieces of skin when he made that point,

Yes.  I was speaking specifically of so-called "gender-affirming" medical procedures.  I even specified the ones I was referencing: penectomies and mastectomies.

2 hours ago, bluebell said:

but he could have clarified that at the very beginning and this side bar could have stopped there.

I think the side bar is something of a red herring.

Removal of a skin tag may technically fall within an overly-broad use of "elective removal of healthy body parts," but I wasn't referring to that, either.

Thanks,

-Smac

Edited October 11, 2024 by smac97

[Calm]

40 minutes ago, smac97 said:

am quoting this article primarily because she is a percipient witness.

Have you ever quoted in this topic a percipient witness who did not support your argument?

I have seen reports by such witnesses, so if it is primarily the fact of being witnesses that counts with you, I am curious as to why you aren’t posting any of those?

[smac97]

4 minutes ago, Calm said:

Have you ever quoted in this topic a percipient witness who did not support your argument?

I have seen reports by such witnesses, so if it is primarily the fact of being witnesses that counts with you, I am curious as to why you aren’t posting any of those?

Feel free to post them, and I'll give them due consideration.

Thanks,

-Smac