[profunctor]

Edit: I did a bit more reading and had a look at an trans group’s reaction to this report: https://transactual.org.uk/wp-content/uploads/TransActual-Br... . Certainly not as clear cut as the article makes it out to be. It seems like a decent amount of the evidence regarding puberty blockers was excluded for dubious reasons.

Interesting article. I have to say I was shocked at the lack of evidence re puberty blockers. I was not shocked that the nhs was trying to hide any true measurements of the effectiveness of its treatments.

At the end of the day we all want kids to have a good, happy life. If puberty blockers are not some easily reversible intervention with few side effects then maybe we should not give them out. Although I’m not sure that it has been proven to be harmful, more research needed?

I am a bit conflicted with the authors opinion that we should not offer full medical transition to adults. I mostly believe adults should be able to do as they wish if they are not hurting anyone (seemingly in accordance with the authors liberal ideology). But we all have to agree that at 18 we were not always capable of making the right decisions for us. I know trans people who transitioned in their late 20s and they are the most happy they have ever been.

Thankfully we have true scientists happy to do the hard yards of creating reports like the one described. Brave and difficult work.

[gresl]

> It seems like a decent amount of the evidence regarding puberty blockers was excluded for dubious reasons.

The systematic review commissioned by Cass on the outcomes of puberty blocking interventions is here: https://doi.org/10.1136/archdischild-2023-326669

The authors' quality assessment of each study is here: https://adc.bmj.com/content/archdischild/early/2024/04/09/ar...

Of the 50 studies in that list, which of these do you suspect were excluded for dubious reasons?

[strangecasts]

> It seems like a decent amount of the evidence regarding puberty blockers was excluded for dubious reasons.

To be precise, the report excluded studies of blockers for not being blinded, in a recreation of the 2003 review of parachute efficiacy [1]

Not that it's particularly consistent about any evidentiary standard, as they happily cite a "self-identified sample of 100 completing an anonymous online questionnaire" later on

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/

[gresl]

> To be precise, the report excluded studies of blockers for not being blinded, in a recreation of the 2003 review of parachute efficiacy

No, studies were excluded for being of poor quality per their rating on the Newcastle-Ottawa Scale, which is a tool used to assess the quality of non-randomized studies.

You can see the review authors' scoring of each study here: https://adc.bmj.com/content/archdischild/early/2024/04/09/ar...

Those excluded have a NOS total score of 4 or less and, as this table shows, a score that low is for multiple reasons including not having a representative cohort and inadequacy of follow-up.

The review itself can be read here: https://adc.bmj.com/content/early/2024/04/09/archdischild-20...

[profunctor]

Yes and to add on to that, the reason this decision is criticised is that it is very difficult or even impossible to properly blind a puberty blocking study. If you give people fake puberty blockers and then they start to go through puberty blockers they will be aware. Same goes for the reverse.