September 2024
Newsletter
NZ media play catch up
After years of ignoring international warnings about puberty blockers, and having barely mentioned the critical Cass Review when it was published in April, the NZ Herald, the Press, Stuff and Radio NZ all today reported that NZ is prescribing the drugs at a rate up to 7 times higher than in comparable countries.
Quoting from a paper written by Charlotte Paul, Simon Tegg, and Sarah Donovan that has been published in the NZ Medical Journal, the reports said, “the authors found that use here was approximately 1.7 times higher than in the Netherlands, and between 3.5 and 6.9 times higher than in England and Wales, and 3.9 times higher than in Denmark. Comparisons with Australia and the US were unable to be made.”
400 children aged 12-18 received prescriptions for puberty blockers at the high point in NZ in 2022. It is unclear why usage has dropped since then but Dr Paul commented that it may be “the result of clinicians and parents becoming aware of more cautious approaches being taken overseas.”
Ruth Hill’s report for RNZ was the most comprehensive, quoting the endocrinologist who reviewed the paper, Paul Hoffman, saying,
“Given this is an expensive therapy and the evidence for its efficacy in transgender youth remains relatively weak, it suggests that Pharmac should ask for a transgender diagnostic category for pubertal suppressive therapy use to confirm its prevalence in New Zealand. While the study cannot categorically demonstrate increased pubertal suppressive therapy use in New Zealand, it raises an important question that needs answering.”
Hill also included a statement from PATHA (Professional Association for Transgender Healthcare Aotearoa) defending the high rate of blocker prescriptions as, "a good sign that young people felt safe expressing their gender and health needs, and had access to services”.
The Herald added a brief mention of the Cass Review as “a four-year investigation by paediatrician Dr Hilary Cass, which concluded that the evidence base for treating dysphoria with puberty blockers was weak” and reported that the British Medical Association, the union that represents 200,000 doctors, has challenged Dr Cass’s findings. However, it didn’t report that the challenge was from the governing council of the BMA, not from a democratic vote of its 200,000 members, over 1000 of whom have signed an open letter objecting to its position.
In this article in the New Statesman, Hannah Barnes reports that, “The BMA was the only major medical group in the UK to consider rejecting Cass. Supportive statements have been issued by the Royal College of GPs, the Royal College of Psychiatrists, the Academy of Medical Royal Colleges and the Association of Clinical Psychologists. Many BMA members were dismayed, some resigning their membership in protest.”
Barnes adds. “Earlier this week, the BMA’s council members voted to “retain a neutral position on the recommendations of the Cass Review… while a BMA task and finish group undertakes its own evaluation”.
The reports all noted that the NZ Ministry of Health’s evidence brief and guide for clinicians on puberty blockers has now been delayed by nearly a year.
Protections for gender questioning children
In England and Wales…
On 3 September, the Department for Education for England and Wales (Scotland is separate) updated its statutory guidance for Keeping Children Safe in Education, including a section on children who are lesbian, gay, bisexual, or gender questioning. (p55 of this document.)
Big improvements from the previous guidance are:
using the term “gender questioning” rather than “transgender child”
recommending caution in undertaking social transition, as advised by the Cass Review
involving parents and medical professionals in all decisions
working in partnership with parents, “other than in the exceptionally rare circumstances where involving parents would constitute a significant risk of harm to the child”.
As this is statutory guidance, schools must follow the recommendations. However, the section covering lesbian, gay, bisexual, or gender questioning children remains under review, pending a report from consultation that closed in March, so any sense of relief will have to wait.
Click here to listen to Helen Joyce talking on Free Speech Nation about these recent changes in the UK and Sex Matter’s new model policy for schools - Sex-based rules and record-keeping.
In New Zealand…
Genspect NZ has written a paper examining the existing Human Rights frameworks and how they apply to protecting the rights of gender questioning children. The Paper concludes:
Genspect has identified a number of current and emerging threats to human rights stemming from the ‘gender-affirming’ treatment model provided in New Zealand paediatric and adult gender clinics. Genspect urges immediate action to halt these gender clinic services which are providing experimental medical interventions to children and adolescents, a significant proportion of whom suffer from mental health conditions. Gender interventions are underpinned by regressive sex stereotypes and affect the child’s future ability to found a family.
We urge the government to ensure that gender services for children operate in accordance with New Zealand’s human rights obligations to ensure that health services conform to the standards outlined by a competent authority. The definition of competent authority must include adherence to the best available evidence. Unfortunately, this currently precludes a number of medical bodies in New Zealand that are dominated by activist interests rather than evidence-based medicine(Tegg, 2024). This requires the Government to insist on the implementation of the recommendations within the Cass Review Final Report in New Zealand paediatric gender services.
Bursting the bubble
Reporting on conversations at the Lobby Day in the UK Parliament on 18 September, where constituents were able to speak to their MPs in person, Helen Joyce wondered how to get through to people as thoroughly confused as one particular MP:
This MP claimed to believe that there are no differences between male and female bodies except for the sex organs; refused to accept that there was such a thing as a “trans woman” who had not had genital surgery; apparently found the statement that “a woman is not the same thing as a man who has had his genitals removed” perplexing; refused to accept that male puberty conveys a strength advantage; and seemed to believe that trans women are already receiving womb transplants and will soon be able to carry pregnancies to term. This is someone who has wide experience of life, and is a parent.
This particular MP has young, virulently activist staff. Presumably they keep their boss away from anyone or anything that might penetrate the epistemic bubble that’s been carefully constructed around them. What would happen if something managed to make it through, and what should that something be?
“The trans lobby would have you believe that this is a story of progress, as young people feel increasingly accepted in their chosen identities. I couldn’t disagree more. This is a social contagion spread in the media, online and in schools, as being trans has been rebranded as a fashionable, high-status identity rather than a rare and tragic medical condition.” Helen Joyce
*Excerpts from Helen Joyce’s newsletter “Joyce Activated,” issues 92 & 93. Subscribe here
Across the ditch
*Thanks to Bernard Lane’s “Gender Clinic News” for the following information. Subscribe here.
Free gender-affirming surgeries
The Australian Society of Plastic Surgeons has applied for full public funding of a range of gender-affirming surgeries for adults, which if successful would mean young people aged 18-25 with still developing brains could undergo “depathologised” trans surgery; access to these procedures would not be contingent on patients experiencing any clinical distress arising from rejection of their birth sex.
Evidence check
“The research shows that these [puberty blocker] medications are safe and work well to delay puberty, and their effects can be reversed if stopped. Some studies also suggest that this treatment can help reduce the distress young people with gender dysphoria feel during puberty.”
So says the headline-grabbing summary for an “evidence check” of medicalised gender change for minors commissioned by government health authorities in NSW, Australia’s most populous state.
The report itself characterises the evidence for puberty blockers and other gender medicine in ways that repeatedly undermine the reassuring summary, for example—
“Weak due to poor study designs, low participant numbers and single-centre recruitment.” “[C]onsiderable flaws remain in the evidence”. “[T]he strength of the evidence remains poor.”
Even the summary gives the lie to its own over-confident endorsement of gender medicine - “Overall, it is difficult to draw definitive conclusions about interventions for gender dysphoria in children and young people from the available research.”
Sense in Sweden…
Young people with immature brains cannot grasp the consequences of irreversible gender medicalisation, a prominent Swedish child and adolescent psychiatrist has warned.
“It is my opinion that the irreversible measure of sterilisation should not be carried out until the age of 25, and it is therefore appropriate to have the same age limit for gender-reassignment treatment for gender dysphoria,” the psychiatrist, Dr Sven Roman said.
“[In the adolescent brain, the] frontal lobe matures last, at 25-30 years of age. This is where overall thinking and judgment are located. A teenager can therefore not understand the consequences of an irreversible sex-change treatment.”
Dr Roman, who trained in medicine at the prestigious Karolinska Institute, said he believed that social contagion in the age of smartphones and social media “largely explained” Sweden’s “astonishing” surge in atypical cases of gender dysphoria chiefly diagnosed among adolescent females.
He made the remarks in an expert report for the American Supreme Court test case, US v Skrmetti, which involves a constitutional challenge to Tennessee’s law prohibiting gender medicalisation of minors. Hearings may begin later this year.
“It is my experience and the opinion of many psychiatrists in Sweden that psychosocial treatment of gender dysphoria for children and young adults should always be tried first [before any talk of medical intervention],” Dr Roman said.
*For more information see “Gender Clinic News” on Substack.
… and in Switzerland
Doctors are “playing sorcerer’s apprentice” by giving gender-distressed youth puberty blockers with unknown effects, the Geneva paediatrician Dr Daniel Halpérin has warned.
“We’re playing sorcerer’s apprentice with young brains and young bodies at an age when we’re imbued with desires, attractions and sometimes contradictory sexual needs. By blocking puberty, we do all sorts of things whose long-term consequences we don’t measure.” Dr Daniel Halpérin
Dr Halpérin made the remarks in an interview with the Geneva Tribune newspaper, following the August 22 publication of an appeal for patient and cautious response to gender distress from three eminent Swiss doctors.
In their appeal, the doctors note an increase in transgender mastectomy from one case in 2016 to 114 in 2021 involving girls under the age of 24. They say gender distress has become “a major social issue” driven more by ideology than science. “We can no longer ignore the growing number of cases of ‘detransition’, in which young people express regret (and sometimes anger) at having allowed themselves to be drawn into these therapies, and we must be clear in admitting that the data in the medical literature supporting the benefits of these interventions are based on a very low degree of certainty.”
“Priority should now be given to an approach that focuses on the child’s best interests for his or her present and future life, an approach that is cautious and patient, addresses the psychiatric co-morbidities so common in this population, and endeavours to understand the origins of [gender incongruence or gender dysphoria] through attentive, empathetic listening over a period of maturation.
*Excerpts from “Gender Clinic News” by Bernard Lane.
New on our website
Click here to listen to this wide-ranging interview with Stella.
Click here to watch Helen Joyce speaking on Spiked.
This very useful guide from Bayswater Support Group (a UK group that supports parents of trans-identifying children) describes some of the key risk factors for gender questioning children:
Overlooking and failing to address other issues: e.g. ASD, ADHD, mental health issues, eating disorders, sexual abuse/other trauma, severe bullying, confusion over sexual orientation (e.g. internalised homophobia).
Likelihood that a student may take harmful physical steps to change their body in line with their attested gender identity, e.g. binding, tucking, hormonal interventions, including circumventing NHS protocols by procuring items online.
Exposure to inappropriate/inaccurate online information and/or adult influence (including explicit sexual content).
Parental alienation due to a culture where children are encouraged to keep secrets from anyone they suspect may ask questions about their desire to socially/medically transition.
Thanks so much for this - an excellent round-up of recent articles and interviews of interest & importance. I’ll be sharing this far and wide 👏🏻