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naraburns  nihil supernum  1yr ago (text post)   35018 thread views

Culture War Roundup for the week of April 3, 2023

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To be clear, we're talking about puberty blockers, which "are falsely claimed to cause infertility and to be irreversible, despite no substantiated evidence".

While your response is ok in the context of raggedy's bombastic claim, I'd like to caution that this "falsely claimed without evidence" business is itself rather bombastic. What they most likely mean by that ist that there is no evidence blockers directly, permanently, and reliably cause infertility. What they most likely don't mean by it is that there is no evidence for any impact on fertility.

Right off the bat, we are talking about a drug that is also used for chemical castration, so it would be wild if it didn't have at least a temporary impact on fertility. Secondly there's the question of when the puberty blocking is started, if you block puberty at or before stage Tanner II, where by WPATH's Marci Bowers' own admission even your ability to orgasm is seriously impeded, would that have no impact on fertility? Various gender clinics are quite cautious on that:

Where puberty has been suppressed through the use of blockers there are no immediate fertility options, as the sperm and eggs have not matured. However, this is not a permanent state of affairs (and, as Ehrensaft and Hastings remind us, no one – regardless of gender identity – has ‘guaranteed’ fertility options.)

 

Use of GnRH analogues might also have long-term effects on:

- Growth spurts

- Bone growth and density

- Future fertility — depending on when pubertal blockers are started

I found another paper that seems to have a more sober tone, and even your Lancet article seems to have resulted in a lot less bombastic follow-up, but SciHub not being what it used to be, I couldn't verify what exactly they said.

EDIT: Originally I thought they meant "irreversibly cause infertility", but I just noticed that the reversibility claim is made separately from the claims about fertility:

are falsely claimed to cause infertility and to be irreversible, despite no substantiated evidence

That's just an outright lie. There is no way to bring a person back on their original development trajectory after they have been affected by blockers. Neither the article, nor the paper cited under "no substantial evidence" link addresses the reversibility of the effects puberty blockers have on a person.

(Scandinavian rules, as @arjin_ferman points out, are much more restrictive)

I want to emphasise that it's shaping up to be a European, not just a Scandinavian thing. The UK also restricted their standards, the French National Academy of Medicine issued a statement urging caution, and the Belgian Center for Evidence-Based Medicine is throwing heavy shade at the state of research as well.

The WPATH standards, which are on the radical side of global medical opinion emphasize social transition, then possibly puberty blockers, then possibly cross-sex hormones, then possibly surgery.

Maybe this is what you meant by "on the radical side" but it's worth noting that after publishing the original version of the SOC, that various researchers actually signed on to, they immediately issued a correction removing the minimal ages for gender affirming procedures. There's a whole bunch of other controversies resulting from the latest SOC which, personally, put the credibility of the entire organization in question, but that's not related to your point.

To the extent that it looks like this standard of care isn't being followed, those reports are themselves untrustworthy.

Keep in mind that the reports that these reports are untrustworthy, are themselves untrustworthy. The people who were originally casting doubt at Reed's story are now claiming she/journalists committed HIPPA violations by providing evidence.

There is no way to bring a person back on their original development trajectory after they have been affected by blockers.

Well, yes, in a very literal sense, there's no such thing as an action without consequences in the most general sense, but the drugs do not appear to be horribly dangerous in the general sense, which is why they're used for kids who are going through puberty at the wrong time.

For scale, I'd point out that we regularly perform surgery on healthy adolescents, as well as on infants, sometimes in ways that make them very definitely infertile, but despite considerable activism, this hasn't become nearly as much of a major issue, likely because these things are done to make children more gender-conforming, as opposed to less.

The level of concern about potential bone-density impacts, for example, seems disproportionate compared to the way we disregard much more serious issues when no one involved is gender-nonconforming.

Keep in mind that the reports that these reports are untrustworthy, are themselves untrustworthy.

Reed's claims are pretty straightforward: the standards of care that the clinic was supposedly following were flagrantly violated. This should be, in theory, simple to resolve, modulo medical privacy issues. The fact that people who were at the clinic says that their experience doesn't match what she reported seems at least somewhat relevant.

Well, yes, in a very literal sense, there's no such thing as an action without consequences in the most general sense

There's plenty of medical procedures that you can go through, that even if they make their mark, it will be hard to spot years down the line. If I catch a particularly nasty bug, and the doctor gives me antibiotics, chances are no one will be able to tell I took them after I recover. That's what most people mean by "not permanent" and "reversible". Puberty blockers are not that, and it's not a case of being strictly literal to point it out.

but the drugs do not appear to be horribly dangerous in the general sense,

This is shifting the goal posts. You can't accuse people of "falsely claiming with no evidence" that they're irreversible and can cause infertility, only to switch to "aside from their permanent impact on the development trajectory, they don't seem to have that many side effects".

For scale, I'd point out that we regularly perform surgery on healthy adolescents, as well as on infants

The former is a cosmetic surgery, which we make clear from the start, so the patients and their parents can actually make an informed decision. I'm also pretty sure it's effects are less serious than blockers (and if not, then it's also insane that this is allowed).

The latter is barbaric, and one of the reasons arguments from authority ring hollow to me.

which is why they're used for kids who are going through puberty at the wrong time

Deliberately and permanently altering a development trajectory again shows that the drug has very serious and permanent effects. Taking it at a time when the kid is supposed to go through puberty means they will miss out on important stages of development. It's insane to me that academic journals have the balls to call that reversible.

The level of concern about potential bone-density impacts, for example, seems disproportionate compared to the way we disregard much more serious issues when no one involved is gender-nonconforming.

You seem to be painting a picture that "lower bone density" just means living a mostly normal life, with maybe an increased risk of braking a leg, or something. While that's relatively accurate when you're young, things start getting a lot more serious by the time you hit your 30's, when you might start feeling the effects of early onset osteoporosis.

Contrary to your claim that gender medicine is met with disproportionate scrutiny, the truth is the opposite. We turn a blind eye to serious side effects of gender medicine, which we would never allow in other cases.

The fact that people who were at the clinic says that their experience doesn't match what she reported seems at least somewhat relevant.

The fact that Reed said all her claims are documented and verifying them is a question of a simple subpoena, while the other side is screaming about HIPPA is even more relevant.

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