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July 31, 2024 - 8:15pm
The British Medical Association has criticised the Cass Review for allegedly using weak methodologies to support its findings, according to a Wednesday announcement.
The BMA called for the Cass Review’s implementation to be halted, and for cross-sex medical treatments to continue “regardless of [patients’] age]”. It plans to publish a full critique at the end of the year, which is slated to focus on “weaknesses in the methodologies used in the Review and problems arising from the implementation of some of the recommendations.”
The Cass Review cast the British medical establishment’s handling of youth gender distress in a harsh light, finding insufficient evidence for sometimes irreversible treatments that were administered to troubled adolescents, many of whom were autistic. Dr Hilary Cass, a former President of the Royal College of Paediatrics and Child Health, investigated the evidence behind cross-sex medical interventions for minors including puberty blockers and hormones on behalf of the NHS, which had been offering the treatments through the Tavistock Gender Identity Development Service. The Review, published in April, found that medical treatments were in most cases not the best course of action, and instead recommended a focus on mental health treatments.
“The rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health. The effect on cognitive and psychosexual development remains unknown”, the report read.
The BMA is joined by several other organisations, including a group of researchers at Yale University and a separate group of university researchers in the UK, that have criticised the Cass Review. These organisations have defended youth gender transitions, arguing that it will be used to politicise transgender health care and justify legal restrictions on gender transitions.
Dr Cass has previously characterised much of the criticism directed at her report as inaccurate. “If you deliberately try to undermine a report that has looked at the evidence of children’s healthcare, then that’s unforgivable,” she said, “you are putting children at risk by doing that,” she said in April.
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SubscribeTwo quite telling quotes.
First, that the BMA does not see that this is already politicised, and inevitably so. This is not measles or flu, from the very outset it has been tangled up with gender politics.
Second that it sees this as just a matter of letting the experts get on with their job – without outside critique or control. We know best. This shows an extraordinary faith in experts given the track record.
From the BMA announcement.
Disingenuous because patients will only have the advice of clinicians to go on, and little ability to evaluate its soundness. But also it looks like a spat between professionals and politicians with the professionals galled that politicians should interfere.
This also deliberately obscures the facts that a) that Cass is a doctor herself and not a politician, and b) that she has looked at the evidence (including, but not limited to, the ‘best available). The BMA statement therefore looks like an attempt to smear her.
No, Cass was a political appointee and acting as a politician in producing her report. She very much avoided looking at as much of the evidence as she calculated she could get away with, for the purpose of claiming there was too little evidence, falsely giving the appearance of a scientific/medical excuse for restricting/prohibiting the current very successful standard of care.
She has smeared herself.
It was the evidence-based medicine team at University of York that carried out the reviews of the available scientific evidence. These were published separately and fed into the Cass review. If you read the University of York reviews it is quite clear that Cass did not distort their views.
York looked at ALL the evidence. It was a smear originating in the States that claimed they did not … a smear believed by all those who desired to believe it. Just because a scientific study is done does not mean it is high quality. No doubt your “evidence” is some low quality observational study hardly worth the paper it was published on.
What fed the Cass Review was not what good evidence there is.
“York looked at ALL the evidence.” <– No, they did not. You put up links to exactly 4 articles, which without checking for duplicates reference 290. There are in fact thousands., most of them of a quality as is used in most medical research.
Don’t lie to me you moron, or for God’s sake tell better lies!
I’ve noticed you frequently insult people you disagree with. Firstly, this undermines what you’re saying and looks laughable to others who read your comments. Secondly, this behaviour is straight out of what’s referred to as the Dentons document.
Amongst many other things included in the document, if someone presents a coherent, well-informed argument, especially if it includes facts based on science, which are difficult to refute, then there are two options. Firstly, ‘no debate’ as stipulated by Stonewall. Second option insult the person making the statement which is what you do.
I’ve noticed you confuse accurate description with insult, also that you have no facts backing up your opinions which you can cite. I have seen you repeatedly confuse what you like with being a fact.
I have no idea what this mythical “denton’s document” is, and I note you can’t link to it either — or for some reason have chosen not to.
Utter bollocks.
Telling too that the BMA statement refers to the “old adage in medicine of ‘no decision about me without me'”, rather than the more fundamental “first do no harm”.
I noticed that too.
Just skimmed the American research referred to by the BMA, and the message to politicians to keep out of our business comes across loud and clear.
It is only Cass and her ilk attempting to do harm
Only a drooling halfwit; sorry, you are an expert having studied this for 40 years would make such an asinine comment.
Other than the fact it is the obvious truth.
Withholding gender affirming care with respect to medical transition of apparent sex and gender, from those who meet the criteria for it, is for the youth involved forcing boys to have breasts and periods and forcing girls to have beards and deep voices.
It is monstrous, clear harm.
It is monstrous, clear bo!!ocks that you are spouting.
“Withholding gender affirming care with respect to medical transition of apparent sex and gender, from those who meet the criteria for it, is for the youth involved forcing boys to have breasts and periods and forcing girls to have beards and deep voices.”
Gibberish and poppycock. Google that.
Then prove it.
I know you cannot. I know what I claim is already proven.
What we are arguing about is whether your lies will be allowed to rule the day.
“Gender affirming care”. What on Earth are you gibbering on about? The case is precisely the opposite. There are two biological sexes, and the concept of gender in this context is devoid of any meaning.
We are talking potentially about irreversible treatments involving the amputation of penises, the creation of faux vaginas, and the life long administration of drugs, whose long term effects we do not know. That is legalised child abuse, and it will be seen as such in years to come. It is revealing that the “best” country in the world for rapidly “transitioning” youth is Iran.
Well meaning as you are David, you do not go far enough. Recourse only to the reasonable man ( or woman ) on the Clapham omnibus should be sufficient. Transgenderism is a nonsense. The more experts meander in to the debate, the more the arguments go. The BMA needs to grow a pair and say what the majority of their membership thinks. The higher levels of the BMA are composed of a few who, instead of seeing patients on waiting lists, have spent valuable time climbing the slippery pole.
As a doctor, can I reassure fellow readers that the BMA, like other unions, is much more left leaning or “progressive” than its members. Their response to the Cass review doesn’t therefore surprise me. I think, hope, most of my colleagues would pay more attention to the Cass review than the right on pronouncements about of our union.
Who is it in the BMA that is making these counter-proposals to the Cass Report? Since ‘Gender’ theory is an unproven set of ideas rather than a medical matter, doing so seems suspiciously like the work of believers in the theory, rather than scientifically minded investigators. Have they been influenced, too, by the pharmaceutical giants who hope to make billions from transgenderism? Just asking.
The BMA is a trade union for doctors and intrinsically left-leaning (consistent with Conquest’s Second Law). It is also an academic professional association. Unfortunately it sometimes gets these 2 roles mixed up, hence the lurch towards Woke.
The BMA has no authority over doctors, and the majority of doctors wouldn’t support its latest spat with Cass.
Whose slippery pole?
Haha. My apologies “greasy pole “.
Why would the BMA say this now, before releasing its full report in the fall, at which time its report can be critiqued?
Because they have read the pastiche of research which the Cass Report is, and already see fulsome grounds on which to criticize it.
Such as this:
https://law.yale.edu/sites/default/files/documents/integrity-project_cass-response.pdf
Yet this is not how the scientific process works. You publish your findings and then make your statements, just as Cass did.
Yes it certainly is how the scientific process works! There is nothing out of line with showing error in the work of others — in fact it is a part of how error is prevented from propagating.
It is not peer reviewed. It has no declaration of interests. And two of the references I checked are not peer reviewed papers but published opinion. This is junk built on nonsense.
It is itself peer review of Cass’s work, and criticism of that work is the interest.
“This is junk built on nonsense.” <– Yes, that is a fair description of Cass’ report. It was designed to support the conclusion there was no good evidence, and arrived at that conclusion by discarding evidence baselessly.
Self appointing yourself and some fellow travellers as peers and then writing a review isn’t how peer review works. Either you know this and are trolling or you don’t and you’re yet another activist filling the internet with fallacies.
This is not myself writing the Yale document, and the people writing the Yale document are not recruited from the street.
I have no reason to suspect you have the slightest knowledge of how peer review works.
You, being such an expert on language and grammar, should be aware that the use of ‘myself’ is incorrect. The correct word is ‘ me’. Oh dear!
A) Emphasis lost on you.
B) Not a substantive reply to the matter either.
1: So-called emphasis is only proof of ignorance. As usual, you try to bs your way through these comments.
2: I don’t bother with substantive replies to complete and utter garbage. Stop posting it and people would engage with you on a meaningful level. Don’t and take whatever is served up.
No, you finding actual facts which refuted me would be proof of ignorance on my part, or at lest of my being in error. Instead, there is only evidence of ignorance on yours.
The BMA’s view all seems like common sense, but I’m going to keep an open mind until I see if Champagne Socialist agrees.
Of all the bizarre conceptual flip flops in this area, the one that most astonishes is that around the term « gender ». How, in such a short time, can a concept (largely feminist) referring to a socially conditioned role coming decidedly from outside the individual – have flipped into some sort of essence coming decidedly from inside the individual.
The first version is a kind of socially imposed or conditioned mask women (and arguably men) are forced to wear – a kind of distortion of their true self. The second is who you really are, your true self.
Oddest of all, during their tenure both versions have been accepted as true representations of reality, and used unquestioningly to interpret that reality. Indeed, the one has slipped into the place of the other without even much notice.
Gender has referred to the masculinity and femininity of people in the English language since the importation of the word from Old French. You are complaining about a 700+ year old usage as if it were new.
It was feminists radical to their day who tried to make it something imposed by patriarchy instead of arrived at ad hoc.
No, gender refers to the grammatical properties of nouns and adjectives, in English masculine, feminine or neuter. Biological organisms have a sex, words have a gender.
No, in English it never has. In fact English had almost completely lost grammatical gender by the time the word came into English. It has never in English referred primarily to grammatical gender.
The charitable interpretation is that you haven’t been alive long enough to have experienced the reality of the usage. Chambers Twentieth Century Dictionary (1972): gender, n. kind (obs.); distinction of words roughly answering to sex (gramm.); loosely or jocularly, sex.
When I was young, in the 1970s, the use of ‘gender’ was exclusively grammatical. The earlier much more general use ‘kind’ (from Latin genus) had long been obsolete.
I wonder why you are lying to me quote so blatantly? Gender has referred in English usage to the masculinity and femininity of people and not as a grammatical category, for over 700 years.
Subjectively characterizing the common usage as jocular is not evidence it was not the common usage.
Nonsense. In English it refers to the properties of nouns and adjectives _in other languages_. Nothing else.
But I suppose you would try splitting hairs if you were being denied your main aim of mutilating children and stopping their parents protecting them.
I’m not splitting any hairs — I am correctly stating what the word means in English.
I have no such aim — it is clearly however yours.
In English, we need to talk about languages other than English. ‘Gender’ is correctly named as a grammatical term. It became a euphemism for ‘sex’ in the 20th century, primarily in American English. This euphemism was then naivly used by feminists to mean sex, as if that had been its meaning all along, which brought us to the present, confused state of understanding.
Don’t argue with Tellingya Porkies. She is all knowing and all seeing. A polyglot and polymath. Awesome in everything! I worship her.
I can see why you feel that way, and resent it and write it satirically — but you might yourself try only writing about what you know something of.
“In English, we need to talk about languages other than English.”
No liar, it is in English we are reading and writing, with English being the language with which you are attempting to deceive. It is the English language usage of the word which is a part of the matter here, and none other.
Have you also spent 40 years studying this?
It is obvious in only 5 minutes of looking up the etymology of the word and its usage.
So you haven’t spent any time at all on this; you obviously don’t bother past the point that satisfies your feeble attempts at erudition.
It is a ridiculous assertion that in the English language, the word gender refers primarily to categories of words in grammar. The fact this is immediately obvious on only momentary investigation is an artifact of the deliberate dishonesty to the claim so made. No more or less.
Before you start pontificating on etymology, you should be sure to learn how to differentiate between its and it’s; but don’t tell me: you’ve spent forty years studying it.
Why no, you have no substantive reply.
Surprise, surprise: another illiterate response.
And another lie from you is no surprise at all.
Ha ha, I love your posts, Talia. As this thread has progressed, you have increasingly resorted to insults and abuse: a sure and undeniable sign that you are losing the argument. Excellent.
No imbecile, solely that you are a troll.
More illiteracy from the Queen of Solecism
Except I am the person mentioning what 99%+ of medical professionals know to be real, and you are supporting the least well educated <1%. These are very far from my idea alone.
You do know what solecism actually means, right?
This has happened with lots of words. Few people know the original meaning in the first place and then the definitions drift. I was fairly shocked a few months ago when even posters on here no longer defined racism as being about ethnicity.
The first time I encountered the word gender was decades ago, in a questionnaire asking whether I was M or F. I assumed it was just a polite way of asking what sex you were. It wasn’t till all the discussion of gender kicked off a few years ago that I looked up what it actually meant, and the history of the word as you’ve described.
Sometimes of course it doesn’t matter, and sometimes it’s just drift or scope creep. More things would count as racist nowadays than would have done so in the past. What is astonishing about “gender” is how such a radical change has slipped in under the radar.
Yes, it is an extreme change, almost a complete inversion. There’s effectively two words (three if you include genders in languages) with the same spelling but different meanings, like wind and wind. Only unlike that example people are generally unaware of the different meanings.
Incisive. Believing two contradictary things at once – what can one do but indulge the feelings of the moment … until the next moment?
Many indigenous and cultures across the Indian sub-continent have roles for people who are inclined towards expressing their appearance and sexuality as that of the opposite sex. In Australia Aborigines thus inclined are called sister-girls and brother-boys. They have not gone so far as tribal medically sanctioned mutilation to remove or add anatomical bits to or from themselves. This seems a peculiarly Western habit. So it is quite an old custom and if I were unfortunate enough to have a biblically inclined neighbour I’m sure they would find an example in Judeo-Christian texts.
“They have not gone so far as tribal medically sanctioned mutilation to remove or add anatomical bits to or from themselves.”
So what?
I am only aware of modern medical technology permitting anything like a functional, aesthetically acceptable result.
Exactly my argument, Talia. The Western trans movement is an un-natural surgically enabled hijacking of a cross cultural natural occurrence.
It is no more unnatural than antibiotics and all of human biology is equally “cross cultural”.
Is this how The Science now works at the BMA? Announce you’re going to prepare an independent critique over the next 4 months, then publish the results. But immediately pre-empt all of that and decide the conclusion now and attack all those that disagree. The world could save a fortune in science research and investigations of all kinds if we followed the BMA’s approach. Truly they have broken free of the imperialism of the enlightenment and empirical science (which frankly always sounded a bit too much like imperial).
More than merely fair grounds on which to utterly invalidate Cass’s report have been obvious as soon as it was published. It is an example par excellence of cherry picking, and nothing other.
Ah, The Science is obvious. Yes, that’s exactly how it works.
The problem with Cass’ report was published and obvious in her report, which was among other things her inclusion/exclusion criteria.
The BMA have not published any such thing. The BMA is the subject of the article and the thread and my last comment. Don’t make stuff up. You’re not helping yourself.
The Cass Report published it’s own criteria — anyone can read it. Those inclusion/exclusion criteria overall were a joke, and that was immediately noted at the time. It was a dead letter with no credibility.
Talia, you seem to be very confused. I assume you are referring to the inclusion/exclusion criteria used in the 6 independent systematic reviews commissioned FOR the Cass Review (which are therefore not exactly and simply ‘Cass’s criteria’)? These all use quite standard inclusion/exclusion criteria – e.g. if you look at the one on puberty blockers, you’ll find that exclusions occurred primarily because they were not peer-reviewed intervention studies looking into the actual treatment for which the evidence is being assessed. One was excluded because it is not assessing outcome measures relevant to the review’s scope, etc. Observational studies were included, including those that were relevant but rated moderate quality. I don’t know why you would have a problem with an evidence review insisting that the evidence used to inform healthcare be of moderate or high quality and be peer-reviewed and be evidence relevant to the health concern in question?
IF you are competent to understand the standard processes of clinical evidence reviewing, I suggest all you need to do is look at the systematic review I just cited and you will find an absolutely garden-variety piece of work in the genre: https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326669.full.pdf
If, however, as I suspect, you don’t have any relevant expertise in clinical evidence reviewing, I suggest a but of humility may be in order.
I refer to the inclusion/exclusion criteria published with the Cass Report, several of which by themselves prove those criteria were employed for the purpose of excluding the bulk of relevant so the conclusion could be claimed to be true, that there was too little data.
no credibility? its been accepted by governments of both stripes and the majority of the medical profession/ NHS etc. just a few complete nutters like you and the communist public school halfwits of the BMA committee. its you that has no credibility, or evidence, or research to back you up. embarrassingly so.
“its been accepted by governments of both stripes” <– So what? They agree with the politics of it.
“and the majority of the medical profession/ NHS etc” <– Horseshit. The BMA, APA, AMA — they are not complete nutters and “communism” has nothing to do with it.
Your citing shows you are the nutter.
It was obvious over twenty years ago when gender affirming care supplanted all other treatment approaches. It is only more so now.
Not it isnt and you are not qualified to make such a statement. Here is the evidence. The conclusions are clear and robust.
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326669.full.pdf
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326670.full.pdf
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326499.full.pdf
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326500.full.pdf
This is the evidence base of the Cass review.
I have studied the topic for over 40 years, I am qualified to make this statement — the inclusion/exclusion criteria of the Cass Report, including the quite limited number of papers looked at to begin with, were designed to substantiate the desired conclusion that there is insufficient data to support the current treatment model of the WPATH Standards of Care.
You have cited nothing to the contrary.
I call BS on your ‘study’.
And why exactly, when you have no factual points to make whatsoever, do I care?
Which criteria, Talia? Name the inclusion/exclusion criteria in the reviews that you are asserting are designed with the aim you claim in mind. If you can’t actually point to the specific criteria that you think should have been different, then your argument lacks any basis.
The fact you are claiming I “can’t” when I already have here at The Herd is amusing.
Merely this single of the several exclusion criteria, eliminates from the US at least 93% of all data, because 93% of people beginning transition as youth complete it at the time the study was carried out, as an adult.
“Studies of mixed populations unless the results for those with childhood gender incongruence, gender-related distress/dysphoria or those referred to a gender identity service in childhood are presented separately.”
The criteria were designed to justify the conclusion.
You have certainly not studied the ‘topic’ of unbiased systematic reviews of evidence used to determine what works and what doesnt by medical and clinical professionals. Every drug you are prescribed in every country in the world passes through this methodology and your supposition that the Cass review was designed to substantiate a conclusions shows you are clueless about how to review evidence. If you recruit 15 transgender patients to a study and give them hormones and then ask 6 months later a simple question like ‘do you feel better?’ then this is not a study that can tell you anything clinically or medically. These are useless studies and are in no way anywhere near scientific enough to justify giving kids off label cancer drugs and making them infertile with surgery.
I have cited 4 papers that set out the objective unbiased methods that were deployed to address key clinical and medical questions. You made an unsubtantiated supposition and dont understand evidence based medicine. The BMA take their lead from online activists like yourself and unfortunately you and they are ‘on the wrong side of the science’.
Nothing you have said has anything to do with it. At all. It is only what you wish were true.
You cited 4 papers which detail what is ideal, and the fact is almost all medicine — and Cass has agreed — is not carried out based on what is called “high quality” evidence; because it is not possible carry out research producing what is called “high quality” evidence.
So evidence the equivalent of what most medicine is based on should be considered.
You have posted what is not merely irrelevant, but what is evidence of exactly how Cass cherry picked her way to the conclusion she politically circulated would do her the most good.
You are on the wrong side of the science, by ignoring what actually is. The same as Cass did.
I’ve already mentioned how her criteria would have removed from consideration about 93% of all data from the US, without regard to it’s value. That is real.
It’s a political move. And the BMAs claimed desire to avoid the issue becoming political is, ironically, a political move too. And rather sadly, the conjuring up of “science” to back up one’s position has become largely a political move too – only used when it suits you.
Well someone has to try to save the British medical establishment from being a laughingstock, a la Wakefield.
Don’t forget Finland, Denmark, Sweden and Norway. They’re all laughing stocks as well.
Yes, they are. They have no factual excuse for any of their changes in policy with respect to transgender people.
That is why you have only ever been able to quote ostensible reasons and never any facts behind them.
Grateful you don’t work in my faculty
Your biases are on full display.
I am biased towards proven reality. You have contrary notions.
Give it a rest fellah
I’m not a fellah. When you stop attacking people baselessly, I’ll be happy to not need to defend them, or to point out those lies you love and repeat.
No one is attacking people here, just ideas that are highly questionable.
It is a lie to claim the ideas attacked here by the Herd are questionable at all, let alone, “highly”.
And of course, transgender people are being attacked — they are being told variously that they have no right to be happy, or, that they do not even really exist … but are mentally ill cisgender people.
Why do you bother gaslighting me with your ridiculous lies?
“Be not blind to a friend’s faults, nor hate him for them.” (Publilius Syrus)
In response you have a quotation of no relevancy.
They’re here, they’re queer, they’re coming for your children.
Says you praising the abuse of some children — which is necessarily what opposition to gender affirming care is.
He’s quoting what trans activists sing. You should know.
The satire of which is lost on you, in the few instances it has ever been said by any LGBTQ person.
That last time I heard that claimed, it was an onlooker to a parade, and no one involved in the parade saying it.
What the BMA should do, quite obviously, is publish research which confirms the benefit of puberty blockers in appropriate subjects. Cass was unable to find any such research, and before the BMA advocates for the treatment it must show that is is proven to be effective. They are supposedly the bastion of research-based medicine, after all. But no. This is a transparent spat over power and the BMA brings itself and the medical profession into disrepute by its stance.
I skim read the American research that the BMA refers too. Their position is that puberty blockers used appropriately do not cause a problem, either in the trans case, or in the case of children who enter puberty too early. Specifically they do not cause problems for cognitive development – again if used appropriately.
So what does appropriately mean? It means (and they say explicitly that this is what Cass should have said) that children should be moved quickly from puberty blockers onto cross sex hormones! Inconsistently, they also deny that standard treatment for trans children puts them on a pathway towards transition.
“So what does appropriately mean?” <– The current standard of care, which is currently for no more than 5 years at the outside and no less than 1 year, for reasons of gender dysphoria.
“they also deny that standard treatment for trans children puts them on a pathway towards transition.” <– There is no such pathway, there is meeting the criteria or not.
The difficulty is that the ultimate outcomes of these treatments won’t be known for decades, by which time, if they are as damaging as a reasonable person would assume, the list of victims could run into the hundreds of thousands.
It’s astonishing that the BMA are willing to take a risk on this scale on behalf of their members, many of whom are likely to wind up with career and life-destroying legal liabilities as a result.
Yes – if, as they say, more research is needed you would expect them to be cautious rather than gung ho.
We are clearly going to have to let the lawsuits rock’n’roll. One senses another blood contamination scandal brewing. Let’s hope the BMA fiots the bill – 1000 famil8es impacted by Tavistock already first in the queue.
The paltriness of the count of lawsuits is itself near conclusive evidence that the WPATH standards of care is as beneficial and accurately recommending medical transition of apparent sex and gender, as is claimed. There are no such 1000 families. Worldwide there are apparently only about 20 in the last 5 years.
I should appreciate your citing a docket to the contrary.
This is very, very disturbing. I have just lost what remaining faith I had in the UK medical establishment. Always thought most of them were quacks anyway. This proves it. I feel sorry for the good, decent doctors who work under this ideologically blinded umbrella group made up of charlatans. I now go overseas for medical treatment, where I get it much faster and at a much higher quality, and much cheaper, too! One day historians will look back over the carcass that was the NHS and British medical establishment and ask, what went so horribly wrong, and why? How did they ever let this happen? Who allowed this august establishment to be captured by extremists and derailed so badly? It’s tragic, really.
I was a member of the BMA once, but I resigned from it 20 years ago. Utterly foul organisation, which bears a great deal of responsibility for the disastrous state of the NHS and the decline of UK medicine.
The BMA is a trade union/professional association for doctors, and the two hats sometimes sit uneasily on the same head. It’s not a Royal College, and it has no clinical authority (although it can advise and lobby and campaign). It’s not compulsory and many doctors choose not to join. Once a member (I am) one has no obligation to do anything the BMA says or recommends. So doctors, thankfully, don’t work ‘under this ideologically blinded umbrella’ and can ignore it’s wilder shores. It has become a more nakedly political organisation recently, and this is evident in its support for the current Labour Government, plus the timing of junior doctor strikes coinciding with the last year of the Tory Government.
Doctors do actually need a strong representative body – largely to prevent NHS trusts from indulging in mission creep in working terms and conditions and weaponizing the intrinsic reluctance that the majority of doctors have not to let patients suffer. This happens a lot – cash-strapped trusts will deliberately reduce doctor numbers on the rosters and drag their heels when recruiting replacement doctors, knowing that doctors will respond by going home later rather than walking off the job with patients still needing them. Most of my shifts (I work in Emergency Medicine) end up with 2 hours unpaid work so that the department I am responsible for is left in some semblance of order and safety.
The BMA has recently become far too left-wing and progressive for my taste; and the BMA Annual General Meeting (where votes are taken on motions and stances are decided) is dominated by a critical mass of left-wing firebrands and activists, who drive the agenda and do NOT represent the less vociferous majority of doctors, who would prefer to be left in peace to see their patients, provided with enough space and resources to do this effectively and not have their intrinsic goodwill towards patients abused by NHS accountants.
Read about Martine (born a man) Rothblatt and you will see how this nightmare began with a bunch of wealthy, transvestite men, and has now become a cult suffocating our youth.
You are actually resorting to attempted sly anti-semitism ?
Being transgender is exclusively biological, Rothblatt has nothing to do with it, other than being transgender.
Who are the BMA ? Who appoints them ? Who psys for them ? Who corrupted them? Are they corrupt as individuals or as an organisation ?
Who can fire them ?
Because anyone with half a brain and an internet connection knows at that this stage that offering ” trangender care ” or whatever they call it to teenagers on indefensible and the BMA support for this practice is creepy and servile ( but to whom ?)
British physicians, and with no apparent corruption whatsoever.
Functionally, you have no brain, because you have no relevant true facts about the matter.
Central to the BMA argument, and that of research they cite, is the claim that trans gender is real, that it is what it seems or purports to be, and that the solution is therefore clear – the current programme of medical intervention.
I think the first point is clearly true. Clearly trans phenomena exist in different cultures and at different times. They are nothing new.
On the second point, we really don’t know what we are dealing with, and concepts like “gender identity” are no substitute for knowledge. There is no guarantee that reality conforms to the concepts we invent to describe it – especially at this early stage of knowledge development. Trans may be multi causal. It may not be a single phenomena at all. We just don’t know enough. Certainly it does not follow from the fact that someone feels they are in the wrong body that they really are – as if they have the wrong body for their soul.
On the third point, transgender is really a misnomer. Treatment is not aimed at gender, it is aimed at sex. Specifically it is aimed at changing sexual characteristics to better match a persons supposed sense of themself. Their gender identity is seen as sacrosanct. But is medicalisation the best approach? Is it in part driven by our own discomfort with ambiguity.
In the past, people who felt at odds with their sex in this way have found non medical ways of coping with this. In my view, masculine presenting lesbians are, in a broad sense, trans. They have both the desires of a man, and a desire to appear more like a man. Have they perhaps found a better way of dealing with the curved ball nature has thrown them?
And if we could find a less intrusive way of bringing someone into line with the body they have (rather than the reverse) should we automatically rule this out, even if it was effective and had less side effects than the reverse. If not, what are we basing this on? That we really do have male and female souls which sometimes end up in the wrong body?
I don’t expect to be popular with either side with these observations.
Excellent comment – the best way to disabuse ourselves of the prejudices of the present is to consider the past, and not just a Hollywood-tinted version of America in the 1950s that some commenters prefer.
To argue that not using modern drugs and plastic surgery is child abuse implies that all historical people were abusive by virtue of not having future technology. It also implies that humans evolved as a species that had, until the C20th, no choice but to abuse trans youths because it did not evolve with an inbuilt “administer puberty-blockers and cross-sex hormones” button to be activated in a psychological emergency.
What would the Romans have done? The Ottomans? There are accounts of trans (usually transvestite which is not wholly aligned with the C21st definition of transgender) people existing in those societies but not puberty blockers or plastic surgery.
“Excellent comment”
It is tedious, irrelevant idiocy where in fact it is not a flight of fancy.
“On the second point, we really don’t know what we are dealing with, and concepts like “gender identity” are no substitute for knowledge.” <– That is a falsehood and a category error — concepts are knowledge, and those who can admit the facts are what they are, knows perfectly well what and who is “being dealt with”.
“especially at this early stage of knowledge development.” <– It is not “early”, it is ongoing for over 70 years. Please acknowledge that. Please also acknowledge the current treatment model outlasted and superceded all others, because unlike them it has proven to be accurate and effective, and it has been the standard for over 20 years.
“On the third point, transgender is really a misnomer. Treatment is not aimed at gender, it is aimed at sex.” <– A falsehood, but possibly merely a misunderstanding. For those who merit it per the criteria in the DSM5/WPATH standards of care, it is the recommended transition of apparent gender and sex to match the actual gender. The actual gender is not the target, and you have not elucidated the gender and not the sex of the person should be the target. The word transgender describes the relationship of a person’s sex and gender as a circumstance had at birth, you have no grounds to quibble with the term.
“But is medicalisation the best approach?” <– For those meeting the criteria for it, absolutely is, and you have no grounds on which to quibble with the point.
“Is it in part driven by our own discomfort with ambiguity.” <– No, because there is no “our” to it. No one is “driving” it but the patient.
“In the past, people who felt at odds with their sex in this way have found non medical ways of coping with this.” <– So what? In the past, no medical way of dealing with this was possible. It has not yet been the span of a full single lifetime since even vaguely modern medical care for this has been possible.
“In my view, masculine presenting lesbians are, in a broad sense, trans.” <– And if your views had not already revealed themselves to be the product of a deranged mind, you have certainly just settled the matter. I should be amused by whatever resulted for you short of death, should you go to the back wall of Babe’s in Carytown, and announce your views to the bull dykes there — I suspect morning would at the kindest see you duct taped, gagged, and quite worse for the wear in the middle of a miscellaneous cornfield in no particular county, and possibly not still in Virginia. I am far more than a little amused just at the mental image of your undertaking your exposition. — Cuing Boromir, one does not simply announce to a masculine lesbian and friends who can lift their own hogs to ride one handed, your opinion they are really men.
“And if we could find a less intrusive way of bringing someone into line with the body they have” <– There is no “if”. That was what was tried and failed for the first 50 or so years. There is no new approach which is the equivalent of that, there is no prospect of it either.
“That we really do have male and female souls which sometimes end up in the wrong body?” <– Souls have nothing to do with what is solely anatomy, and it’s variants.
Unless you are prepared to say a man should be happy to have a female sex, or a woman happy to have a male one, you have nothing relevant to say to the contrary of the current treatment approach of gender affirming care per the WPATH standards of care.
The BMA is not fit for purpose. I look forward to their explanation of why the methods on which the practice of evidence based medicine were not followed in the Cass review. The editors of Archives of Diseases in Childhood will i am sure be raising more than a few eyebrows. These are the publications of the synthesis of the evidence that forms the basis of the Cass review.
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326669.full.pdf
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326670.full.pdf
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326499.full.pdf
https://adc.bmj.com/content/archdischild/early/2024/04/09/archdischild-2023-326500.full.pdf
The current cohort of referees – the largest and fastest growing in history – is overwhelmingly girls, all of whom developed dysphoria and/or adopted a transgender identity after commencing puberty and overwhelmingly in clusters of girls in schools and among friendship groups.
This cohort also appear to develop dysphoria very suddenly, and in tandem with binge watching social media channels such as YouTube or Tik Tok, and spending a significant amount of time in chat groups on websites Tumblr, Reddit and Discord. There, their dysphoria and/or identity will be swiftly validated by strangers who have no knowledge of their circumstances, medical history or any vulnerabilities that may be caused by neurological differences such as Autism or ADHD.
I am extremely concerned that autistic children and adolescents are not receiving optimal care; either in terms of their Autism being recognised, or taken into account when under the care of gender identity services.
76% of referees to The Tavistock & Portman Gender Identity Service (GIDS) are adolescent girls. The Tavistock’s statistics show that 48% either have a diagnosis of, or show traits of Autism.
Altogether, this is an astonishing number of young people sharing characteristics that are usually only present in 1% of the population. While there is clear evidence that there is a link between the number of children and young people with gender dysphoria or identifying under the transgender umbrella, there is no research that looks at why. Part of the reason for this is that the exponential rise in children and young people experiencing gender dysphoria or identifying as trans has taken place very quickly – too fast in fact, for research to keep up.
There has been an unprecedented overall increase in referrals to the NHS Gender Identity Service (GIDS) of over 3263% over the ten years from 2009 to 2019, with an increase in referrals from adolescent girls over that period of 5337% . With the understanding that a significant proportion of all referrals indicate autistic traits, it may be many more years before we see the results of any research into the reason for this. This assumes of course, that such research is taking place at all.
Both the transition and detransition process (for which there is historically very little support) can be extremely traumatic, both psychologically and physically. There is at present a lack of robust exploration of what causes gender dysphoria, due in part to lack of funding for both CAMHS (Children & Adolescent Mental Health Services) and adult mental health services generally, as well as ongoing cuts to health budgets impacting on service provision at GIDS. Instead, it is easier and cheaper to follow an affirmation model.
The social and political landscape in which children and adolescents are experiencing dysphoria moves and shifts quickly and as more light is cast upon the evidence or lack thereof underpinning treatment guidelines, more and more professional bodies, clinical experts and academics as well as therapists, educators, parents and politicians are speaking out.
In March of 2022 the National Academy of Medicine in France released a statement urging caution in the treatment of gender dysphoria as
‘There is no test to distinguish between persisting gender dysphoria and transient adolescent dysphoria. Moreover, the risk of over-diagnosis is real, as evidenced by the growing number of young adults wishing to detransition [c]. It is, therefore, appropriate to extend the phase of psychological care as much as possible’.
France then joined England, Finland, Denmark and Sweden in restricting or urging extreme caution in the use of puberty blockers and cross sex hormones to treat gender dysphoria in children and adolescents. In America, Dr Marci Bowers, president-elect of WPATH and Dr Erica Anderson, former president of the U.S. Professional Association for Transgender Health, who are among the most noted specialists in the country, have added their voices, expressing concern that children are being fast-tracked to a lifelong medical pathway.
“do no harm”
Unless you are striking for more pay or pushing controversial postmodern theories and ideology, in which case a few harmed patients is ok
I will never understand the BMA
Why haven’t the BMA put Gender affirmation care on hold till they accurately and fully research the effectiveness/downsides of WPATHs recommendations?$ Why put holds on the less harmful approach?$ Why are WPATH’s recommendations accepted as gospel?$
Because it is already fully and accurately researched, having been arrived at as the proper standard of care over twenty years ago, all other treatment approaches having fallen by the wayside as comparatively lacking.
“Why are WPATH’s recommendations accepted as gospel?” <– Because they are the most knowledgeable, practiced person’s in the field.
The question they have to ask is whether the use of puberty blocked can be linked to HEALTH care, with the strong accent of health, as in Huber et all definition of health (BMJ), the ability to adapt and self manage in the face of social, physical, and emotional challenges.
I think it is debatable that using puberty blockers can rhyme with this definition of self managing…. it seem that in the case of puberty blockers it is the doctor and health (illness) industry managing for the patient: fixing the patient like a machine… lots of debate possible
If by that standard puberty blockers are not health care then neither is chemotherapy.
“lots of debate possible” <– But borderline no honest debate about this topic.
The decoupling of gender dysphoria from its original ICD10 (World Health Organization) classification as a mental health diagnosis left GIDS staff struggling to maintain a psychological basis for a condition that the WHO has reclassified as a sexual health issue, so it is unsurprising that there has been no development of a psychotherapeutic treatment pathway.
We don’t yet know the reasons why autistic children were so overrepresented at the GIDS, although issues around puberty and bodily transformation, interoception, sensory issues, theory of mind and the influence of social media all may contribute.
Autism is often described as a system of social and emotional understanding that is ‘lacking’ rather than different. In a world designed for neurotypical people, this creates vulnerability. Autistic children, on a moment-to-moment basis, are not consciously aware that they process and think differently to others, so can’t always spot the areas where their value system is different, or where others may take advantage of them.
An identity which encapsulates many of the issues experienced by autistic children: feeling othered, not fitting in, feeling different to your peers, being gender non-conforming and often feeling that the social mores, behaviours and clothing attached to your sex do not ‘fit’, will be an enticing thing for a child who is used to being ostracised, and who may not yet be aware that they are autistic.
Detransitioner Keira Bell demonstrated exceptional courage in taking the Tavistock & Portman GIDS to a judicial review to try and prevent puberty blocking drugs being prescribed to children. The High Court decision that children under sixteen are unlikely to be able to give informed consent to a treatment that will have far reaching and permanent effects on their bodies, was overturned in 2021 following an appeal. The provision that ability to consent should be established by the courts was overturned in favour of retaining decision making within the medical sphere; however, the evidence base on which the original ruling was reached remains unchallenged. In Bell’s wake, a growing number of detransitioners, many autistic, are gathering their courage and coming forward to express regret at medically altering their bodies to match their feelings. The years to come will see yet more detransitioners and I suspect, more court cases.
That’s not what that press release says. This article is massively clickbait-ish. The BMA is announcing they’re going to assess/review the Cass Review. That’s all.
When my children were young, our GP would frequently respond to my concerns about some ailment or other by telling me, “Don’t worry, it’ll get better on its own”, or “Don’t worry, they’ll grow out of it”. There is now plenty of evidence that this applies to gender dysphoria in children.
Strange that this is apparently the one area of medicine where doctors refuse to take the wait and see approach but feel obliged to leap into precipitate action.
“There is now plenty of evidence that this applies to gender dysphoria in children.”
No, there is no such evidence at all. That is why none such can ever be cited by those who claim it.
Just another formerly reliable institution overwhelmed and consumed by the mindless Woke bullies. Very familiar story by now.
Just another vacuous statement, this time by Daniel Lee, one of no positive valence whatsoever.
The change of Government in Britain precipitated this.
The CASS report sounds like it was recommending a common sense approach for something that can be harmful and irreversible for those who are young and confused.
The final Cass Review of gender identity services for children and young people was published on 10 April 2024. Taking 4 years to complete, it is the most thorough scientific review of the evidence for treatments for gender questioning and gender distressed young people ever undertaken. It was supported by a series of systematic reviews, commissioned from the University of York, on a range of issues from epidemiology through to treatment approaches, and international models of current practice. The Review also heard from a wide range of people including children and adolescents, parents, carers, young adults, and professionals.
https://can-sg.org/2024/04/28/summary-of-cass-review/
And yet it is an example of cherry picking, it was designed to produce evidence of the already desired conclusion.
The Cass Report came to the ‘wrong’ conclusion so the BMA is attacking it.
BMA butchers.
Based on this article it sounds like the BMA is concerned with the methodologies employed in the Cass Review while the Cass Review had several criticisms of the underlying evidence, including methodologies used to justify chemical and surgical procedures on vulnerable youth. Perhaps the BMA can provide solid evidence refuting the findings of the Cass Report before recommending continued use of Puberty Blockers, Cross Sex Hormones, and surgery. Until such evidence shows clear and overwhelming benefit then it seems a permanent ban would be prudent and in the best interest of the patients.
Another thought about the so-called ‘capture’ of medical associations on this hotly disputed topic. I’m wondering if the BMA makes available the total number of members as distinct from the number of members involved with drafting their recommendation. Also, will the vote totals of the entire membership who vote or abstain on the recommendation be made public; and will dissenting opinions of members be publicly available as well as the final recommendation. I think such transparency would be helpful for all medical professional associations.
My GP practice has 20-25 pictures of people framed on the walls round the waiting room. Not one single picture depicts a White man.