Thread by @BayswaterSG

For @BBCPanorama Carl Heneghan, Professor of Evidence-Based Medicine at Oxford Univ, analysed the evidence about medical interventions for gender dysphoria in children. (The Times, 8 April 2019). This is what he wrote. >>

#AskForTheEvidence

Prof Heneghan wrote:
"You would think, when it comes to children, the testing and evaluation of medicines would be robust — ensuring the utmost safety. Well, you’d be wrong." >>

#AskForTheEvidence

"The mess we have gotten ourselves into with the treatment of gender dysphoria in children and adolescents highlights all that is concerning with the present use and evaluation of powerful medicines in this age group." >>

#AskForTheEvidence

"Most evidence for drug use is based on information in adults; evidence in children is scarce, & the majority of drugs in use are frequently supported by low-quality evidence about their use beyond the usual age for puberty, or in many cases no evidence.">>

#AskForTheEvidence

"Drugs in children, therefore, often require off-label use, meaning their use is outside of what the drug was approved for..., including using a drug to avoid, not just delay, puberty & following it with cross-sex hormone treatment.”>>

#AskForTheEvidence

"Children are not small adults... off-label use may lead to serious & life-threatening consequences. In my view given the paucity of evidence, the off-label use of drugs that occurs in gender dysphoria largely means an unregulated live experiment on children>>

#AskForTheEvidence

"Treatments for gender dysphoria in children and adolescents include suppressing puberty & gender-affirming hormones... The collection & evaluation of evidence, particularly when it comes to ensuring their safety, should therefore be a priority. It is not.”>>

#AskForTheEvidence

"The BBC investigation I participated in highlights the considerable uncertainties that require addressing to inform safe care for gender dysphoria. If in doubt, ask for the evidence."

#AskForTheEvidence

And for balance: Dept of Health replied that it “will review any arrangements when appropriate” which Prof Heneghan judged "pitiful.” GIDS alluded to (unspecified) "growing evidence internationally" & that it uses its own (unpublished) research findings "to inform clinical care."