Healthcare in the News

[rev ronin]

16 minutes ago, Febrifuge said:

That’s probably true, yes. All I mean is, people from marginalized communities often develop a pretty good sense of how to figure out whether someone is an ally. 

Which makes sense, of course. While no one should ever be mean or induce stress unnecessarily or unconsciously--see my writings on weight stigma and my ED patients who've suffered from that--being supportive and being objective medical clinicians are different things.

We need everyone--supporter or skeptic--to commit to the highest standards of medical evidence when it comes to treating gender dysphoria. This is too important a topic with too many lives at stake to do EBM haphazardly, or to shy away from tough findings just because they don't conform to a particular ideology, whatever that ideology may be.

[Febrifuge]

Well if we’re going to be reasonable and understanding, then there’s no drama   
 

(I totally agree)

[EMEDPA]

Ok, so my child's best friend since kindergarten used to be "mary", but now prefers " "rodger" . I am glad to call them rodger as have no issues with whatever pronouns they want. Doesn't effect me one bit. . If they wanted me to start them on hormone therapy or cut off body parts I would refuse. There are folks who are comfortable with that. I am not one of them. 

[Febrifuge]

I feel like using hormones to delay pubertal changes is probably fine, since it’s easy to undo. I’m not aware of radical surgery actually being a thing for anyone under age 18.

 

[EMEDPA]

7 minutes ago, Febrifuge said:

I feel like using hormones to delay pubertal changes is probably fine, since it’s easy to undo. I’m not aware of radical surgery actually being a thing for anyone under age 18.

 

I meant hormones to cause secondary sexual characteristics of the gender opposite to that on one's birth certificate. 

[rev ronin]

26 minutes ago, Febrifuge said:

I feel like using hormones to delay pubertal changes is probably fine, since it’s easy to undo. I’m not aware of radical surgery actually being a thing for anyone under age 18.

Is it easy to undo? Stopping one part of a timed cascade seems problematic.

"Research about the effects of early interventions on the development of bone mass and growth – typical events of hormonal puberty – and on brain development is still limited, so we cannot know the long-term effects on a large number of cases."

Giovanardi G. Buying time or arresting development? The dilemma of administering hormone blockers in trans children and adolescents. Porto Biomed J. 2017;2(5):153-156. doi:10.1016/j.pbj.2017.06.001

Do we have any newer evidence on brain development after GnRH agonist use in adolescence? That's what most concerns me, moreso than the bone density and cancer issues, because if the intervention is arresting normal brain development, do gender dysphoric youth receiving puberty blockers really have the capacity to provide consent for surgeries and cross-sex hormones?

Further, the persistence from puberty blockers to cross-sex hormones seems to be quite high--as in, well over 90% but I don't have a real statistic handy--so even if it's possible to reverse, is that really a thing to dig into if it is rare for puberty blockers to not be followed by cross-sex hormones?

[CAdamsPAC]

3 hours ago, EMEDPA said:

Yup. Marginalized communities often includes PAs...

Conservative PAs especially!

[Boatswain2PA]

4 hours ago, Febrifuge said:

Those are disingenuous arguments, and the way they’re twisted around the collision between objective facts and the subjective internal experience of other people’s identity, they imply that anybody can be anything just because they say so. That’s not what this is about. 

But what if I REALLY FEEL like I was born in the wrong decade?  What if I self-identufy as being born in 1960.  I don't just SAY SO, but REALLY REALLY FEEL that way.  Let's say I even self-identify that way.

 

Then should I be allowed to "be" 62? (And start getting social security?)

 

Or what if "I REALLY REALLY FEEL" that I was born in the wrong body. What if I am drawn to all of the stereotypical Amercan Indian lifestyles/culture/etc ad nauseum, so therefore I "self-identify" as an American Indian?  Would one be a racist if they do not validate my self-identity despite my distinct lack of American Indian genes?

[CAAdmission]

8 hours ago, Boatswain2PA said:

Or what if "I REALLY REALLY FEEL" that I was born in the wrong body. What if I am drawn to all of the stereotypical Amercan Indian lifestyles/culture/etc ad nauseum, so therefore I "self-identify" as an American Indian?  Would one be a racist if they do not validate my self-identity despite my distinct lack of American Indian genes?

I say go for it, kemo sabe. 

[Febrifuge]

I’m not responding to that, because either you honestly can’t tell the difference, you just don’t care to understand, or you’re trolling. This is like the “I identify as an Apache attack helicopter” thing the middle school kids were doing 5 years ago. I’m out. 
 

[Boatswain2PA]

31 minutes ago, Febrifuge said:

I’m not responding to that, because either you honestly can’t tell the difference, you just don’t care to understand, or you’re trolling. This is like the “I identify as an Apache attack helicopter” thing the middle school kids were doing 5 years ago. I’m out. 
 

So, help me understand the difference between:

1: I am genetically a man but really, really feel that I am a woman.

2:  I am genetically from a European ancestry but I really really feel that I am an American Indian.

Help me understand the difference here.

Everyone needs to be treated with respect individually, but we don't have to agree with people to be respectful to them.

One ED I work has a XY who has about 300 visits a years.  Sometimes he says he is a he, some days she says she is a she.  Lots of dysfunction there, but this person gets treated respectfully every time.  

As to hormones, blockers, and surgeries - all fine for adults who are paying for it themselves.  Just like if a melanin challenged ginger identifies as an American Indian and wants to tattoo their skin a different color....cool by me.

 

As to the kemo sabe thing....that's just racist man!  Report to HR in the morning for retraining.

[CAAdmission]

No concerns about destroying women's sports?

https://www.nationalreview.com/news/female-high-school-volleyball-athlete-suffers-serious-head-injury-after-transgender-player-throws-abnormally-fast-ball/

[Boatswain2PA]

Wait....but she self-identified as....and was accepted by hollywood as......so does this mean her Mexican family is racist?

https://www.foxnews.com/entertainment/activist-sacheen-littlefeather-exposed-sisters-reported-fraudulent-native-american-identity-lie


I don't want to get political on the general discussion board, but I think the whole dishonesty of "self-identification" is one reason why so many hispanics are swinging politically.

 

[Boatswain2PA]

Also, while the psychosocial "authorities" say that peer-influence is linked to adolescent suicide attempts (https://pubmed.ncbi.nlm.nih.gov/34167026/), different psychosocial "authorities" (specifically Dr. Alex S. Keuroghlian, who directs the National LGBTQIA+ Health Education Center at The Fenway Institute and the Massachusetts General Hospital Psychiatry Gender Identity Program) says that peer influence has nothing to do with the massive increase in teenagers self-identifying as trans over the past 5 years. (https://fenwayhealth.org/new-study-examines-the-social-contagion-hypothesis-of-transgender-and-gender-diverse-identities/)

We all (rightfully) question the motives, and therefore the data, that comes from big pharma.  Why don't we question the ever-changing psychosocial "data" that comes from parties that are vested in a specific outcome from a "study" they do?

But of course, it's now the third rail to question anything...because of "science".
 

I remember when science class taught us TO question EVERYTHING.

 

[Boatswain2PA]

Wait.....are you telling me kids ho through phases?

https://www.nationalreview.com/corner/nhs-warns-gender-dysphoria-in-teens-could-be-transient-phase/

Next thing ya know we will find out kids are influenced by Hollywood culture!

Edited October 24, 2022 by Boatswain2PA

[ventana]

not sure quoting www.nationalreview.com is a reliable source 

 

[Boatswain2PA]

Yes, I understand that some people like to remain in an echo chamber.

Here, let's see if someone will let these other news sources into their safe space:
https://www.dailysignal.com/2022/10/24/uks-national-health-service-finds-most-youths-identifying-trans-are-going-transient-phase-biden-pushes-trans-surgeries-kids/

https://www.telegraph.co.uk/news/2022/10/23/children-who-think-transgender-just-going-phase-says-nhs/

https://www.thetimes.co.uk/article/most-trans-children-just-going-through-a-phase-advises-nhs-dc6dcjf5w

And for those who are adamant about remaining in their echo chamber, here is certified "safe" news source about it

https://www.msn.com/en-gb/health/medical/most-children-who-think-they-re-transgender-are-just-going-through-a-phase-says-nhs/ar-AA13hXt4

Edited October 24, 2022 by Boatswain2PA

[jmj11]

I guess I started this thread and I'm glad to see a healthy debate or conversation. I have nothing to debate or argue here. But I do want to offer a link to my "treatise" on the philosophical and theological considerations for Christians like me, who would not hesitate to call a transgender or gender dysphoric patient the pronoun they prefer and respect those who feel that it is important for them to go through gender-confirming therapies.

Edited October 25, 2022 by jmj11
link didn't work

[CAAdmission]

14 hours ago, Boatswain2PA said:

Here, let's see if someone will let these other news sources into their safe space:

I think this is the original doc:

https://cass.independent-review.uk/publications/interim-report/

[CAAdmission]

14 hours ago, jmj11 said:

I guess I started this thread and I'm glad to see a healthy debate or conversation. I have nothing to debate or argue here. But I do want to offer a link to my "treatise" on the philosophical and theological considerations for Christians like me, who would not hesitate to call a transgender or gender dysphoric patient the pronoun they prefer and respect those who feel that it is important for them to go through gender-confirming therapies.

Thanks for the link to your blog. It was good reading. I'm not big into identifying what other people do as "sin," particularly if mental health is involved. I know there's a crowd that thinks if you commit suicide you bought an express ticket to hell, but I have to believe that if there is a God, there is room for mercy for someone so profoundly troubled. 

I guess like Rev suggests above, I'm puzzled waiting for data. Gender dysphoric people can obviously be profoundly troubled by their experience, and I understand why a healthcare provider would want to rush in an try to provide relief. I'm left to wonder, what is their mental health like 10 years down the road - is it significantly improved? What percentage regret transitioning? What percentage wish to "de-transition?" 

I still have not had anyone take an intelligent stab at any of these questions:

-Is gender dysphoria a pathologic condition or a normal variation? Why or why not?

-Why was there a fairly rapid transition (no pun intended) from psychological treatment to surgical treatment for gender dysphoria?

-What is the difference between gender dysphoria and body integrity identity disorder?

Edited October 25, 2022 by CAAdmission

[sas5814]

This has been an interesting thread. I have, as I stated before, gone back through it several times and re-read the posts. With an occasional aside into finger pointing and name calling it has been a thoughtful discussion. I enjoyed to blogs and links to articles. This is not a subject I know very much about. Gender reassignment and all its attendant issues are almost a non-existent part of my practice so that I can't dedicate a ton of time to it any more than I would spend my time learning to perform an appendectomy. Its important... but what I need is to recognize the issue when I see it and refer to an appropriate specialist. My time is fully consumed on management of chronic illness and there is never enough time for me to feel like I know enough.

What I have learned is anyone who really feels like they have it all figured out...has all the right answers.....doesn't. We have a long way to go before we can state anything about this to a scientific certainty.

Meanwhile.....just be nice.

[LKPAC]

4 hours ago, sas5814 said:

Meanwhile.....just be nice.

I agree.  I don't have to treat someone disrespectfully because I disagree with them.  I don't even have to discuss my disagreement with them in most cases.  But that goes both way.  People who ask for tolerance and acceptance need to be willing to give it to those of us who may not agree with them, either.  I'm tired of name calling.  I'm not a -phobe of any kind just because the woke crowd came up with a new idea they expect me to agree with instantly!

[CAAdmission]

Here's a view of the other side, people who have transitioned and regretted it. Until the proportion of people who feel this way is better known, a lot of caution is indicated:

https://www.theblaze.com/news/my-breasts-were-beautiful-and-now-they-have-been-incinerated-florida-board-of-medicine-hears-former-transsexuals-regrets-drafts-mutilation-ban

[ANESMCR]

That’s some top data there from Blaze Media. The medically astute applaud your research. This really makes me think outside the box. 

Per the article and testimony; One girl grew up in “an echo chamber of far left ideology” and the other “found jesus after a suicide attempt which ameliorated her suffering promoting her to de-transition and accept her ‘woman-hood’”. 
 

Oh my GAWD. 

Edited November 3, 2022 by ANESMCR
Quotations of quotations

[rev ronin]

Given the long-term impact of transition/detransition, what is the acceptable false positive rate--that is, of 1000 people undergoing chemical or surgical procedures to alter their sex characteristics, how many of them deciding to desist or detransition is too many?