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The ultimate pro-puberty-blocker argument is that if treatment is not provided children will commit suicide. Last time I looked at this (mid-pandemic), there were no randomly controlled trials on suicide rates in trans children under different treatment regimens. If you looked at the effect sizes of the few existing small Scandinavian studies about the effectiveness of different transitioning methods on suicide rates, it looked like social transition had about the same effect size as medical transition.
I'm generally in favor of doing more RCTs on children whose parents consent (and on pregnant women). There are so many medical questions that we don't have answers to because medical ethics has raised the standards for informed consent higher than is reasonable.
This response to the Cass review was particularly hilarious: a paper written by two lawyers attempting to dispute the "evidentiary standards" of the Cass review, which manages to misinterpret the Cass review as well as misquote two of the scientific meta-analyses used by the Cass review. If that's the highest quality of argument they can put forward (in NEJM of all places!), then I'm going to guess that the actual "evidentiary standards" in support of their position are quite weak.
(And indeed, the Cass review is up front about there being no RCTs available for use.)
Your Jesse Singal link seems to be broken.
Thank you. Should be fixed, but might be paywalled. The title of the article is "If The New England Journal Of Medicine Doesn’t Correct This Error, You Cannot Trust Anything It Publishes", written on Mar 11, 2025.
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Presumably it's meant to go here (NB: partially paywalled). I don't know what all the extra crap in RR's link does but presumably some part of it requires a cookie you (and I) don't have or something.
Yup. Thank you.
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