Thread on the #keirabell judgement and sorry state of evidence-lead health policy in New Zealand.
We have further confirmation that there is no good evidence of benefit from puberty blockers, and significant risks.
1/11
We have further confirmation that there is no good evidence of benefit from puberty blockers, and significant risks.
1/11
The judges heard evidence for and against, and testimony from former patients. They ruled that puberty blocking is "experimental", with "very limited evidence as to its efficacy"
An unsurprising finding if you're familiar with the literature.
2/11
An unsurprising finding if you're familiar with the literature.
2/11
This is a continuation of the findings from the national health body reviews from Sweden and Finland. Both find that evidence is insufficient.
3/11
segm.org/UK_HighCourt_R…
3/11
segm.org/UK_HighCourt_R…
A review by the Center for Evidence Based Medicine at Oxford University highlighted the "profound scientific ignorance" on the the use of puberty blockers
4/11
blogs.bmj.com/bmjebmspotligh…
4/11
blogs.bmj.com/bmjebmspotligh…
A 2018 review by an Australian expert group finds that all studies on the psych effects of puberty blockers have a medium or high risk of bias.
5/11
fullyinformed.nz/docs/literatur…
5/11
fullyinformed.nz/docs/literatur…
Ok, what about New Zealand?
Dr Jeannie Oliphant is the lead author of NZ guidelines. She described puberty blockers as "the gold standard for young people." and claims that "we are using puberty blockers very freely up until about till about 20".
6/11
pharmac.govt.nz/news-and-resou…
Dr Jeannie Oliphant is the lead author of NZ guidelines. She described puberty blockers as "the gold standard for young people." and claims that "we are using puberty blockers very freely up until about till about 20".
6/11
pharmac.govt.nz/news-and-resou…
The NZ guidelines cite a *single* highly biased study (de Vries et al., 2014) and then claim that puberty blocking is supported by "good evidence"
7/11
7/11
https://twitter.com/fullyinformednz/status/1312158282283249664
The lead author of the original study (de Vries) now believes puberty suppression is not always appropriate.
She believes psychosocial support may be more appropriate for children who have recent dysphoria
8/11
pediatrics.aappublications.org/content/146/4/…
She believes psychosocial support may be more appropriate for children who have recent dysphoria
8/11
pediatrics.aappublications.org/content/146/4/…
New Zealand children have the right to not be subject to medical experimentation. Health authorities must uphold the right to informed consent and provide psychosocial support.
9/11
9/11
If you know doctors and parents who are considering blocking a child's normal puberty, please forward them the judgement
10/11
judiciary.uk/judgments/r-on…
10/11
judiciary.uk/judgments/r-on…
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