Thread by @Bernard_Lane

"They Paused Puberty, but Is There a Cost? Puberty blockers can ease trans youths’ anguish & buy time to weigh options. But concerns are growing about long-term physical effects & other [outcomes]." 1/

@nytimes on the drugs driving the gender clinic boom

nytimes.com/2022/11/14/hea…

"As the number of adolescents who identify as transgender grows, drugs known as puberty blockers have become the first line of intervention for the youngest ones seeking medical treatment.
#health #gender #auspol #politics @BradHazzard @Mark_Butler_MP

"... concerns are growing among some medical professionals about the consequences of the drugs ... The questions are fueling government reviews in Europe, prompting a push for more research & leading some specialists to reconsider at what age to prescribe them & for how long.

" .... the [Dutch pioneering of blockers] has spread to other countries, with varying protocols, little documentation of outcomes and no government approval of the drugs for that use, including by the U.S. Food and Drug Administration.

"But there is emerging evidence of potential harm from using blockers, according to reviews of scientific papers and interviews with more than 50 doctors and academic experts around the world.

"The drugs suppress estrogen and testosterone, hormones that help develop the reproductive system but also affect the bones, the brain and other parts of the body.

"During puberty, bone mass typically surges, determining a lifetime of bone health. When adolescents are using blockers, bone density growth flatlines, on average, according to an analysis commissioned by The Times of observational studies examining the effects.

"Many [gender clinicians] believe they will recover that loss when they go off blockers. But two studies from the analysis that tracked trans patients’ bone strength while using blockers and through the first years of sex hormone treatment found that many do not fully rebound...

"That could lead to heightened risk of debilitating fractures earlier than would be expected from normal aging — in their 50s instead of 60s — and more immediate harm for patients who start treatment with already weak bones, experts say.

"Many physicians in the United States and elsewhere are prescribing blockers to patients at the first stage of puberty — as early as age 8 — and allowing them to progress to sex hormones as soon as 12 or 13.

"But that could force life-altering choices, other doctors warn, before patients know who they really are. Puberty can help clarify gender, the doctors say — for some adolescents reinforcing their sex at birth, and for others confirming that they are transgender.

“The most difficult question is whether puberty blockers do indeed provide valuable time for children and young people to consider their options, or whether they effectively ‘lock in’ children and young people to a treatment pathway,” wrote [UK reviewer] Dr. Hilary Cass...

"On her recommendation, England’s National Health Service last month proposed restricting use of the drugs for trans youths to research settings.

"Sweden and Finland have also placed limits on the treatment, concerned not just with the risk of blockers, but the steep rise in young patients, the psychiatric issues that many exhibit, and the extent to which their mental health should be assessed before treatment.

"Transgender activists across the country pushed for early and easy access to the treatment [pioneered by the Dutch clinic]... Advocates successfully pushed Oregon, Massachusetts, California and other states to allow for Medicaid coverage of puberty blockers ...

"They also helped win approval in Oregon for a variety of medical workers — doctors, nurse practitioners, naturopaths — to administer blockers if overseen, even long-distance, by an endocrinologist ... There is no centralized tracking of blocker prescriptions in the U.S.

"Some doctors and researchers are concerned that puberty blockers may somehow disrupt a formative period of mental growth. With adolescence comes critical thinking, more sophisticated self-reflection and other significant leaps in brain development.

"Sex hormones have been shown to affect social and problem-solving skills. It’s believed that brain growth is connected to gender identity, but research in these areas is still very new.

"In a 2020 paper, 31 psychologists, neuroscientists and hormone experts from around the world urged more study of the effects of blockers on the brain.

' “If the brain is expecting to receive those hormones at a certain time and doesn’t, what happens?” said Dr. Sheri Berenbaum, head of a gender research lab at Penn State, and one of the authors of the paper. “We don’t know".'

"For some medical professionals across the country, there are too many uncertainties about the effects of blockers to provide the treatment.

"Among them are 7 pediatric endocrinologists & pediatric endocrine nurse practitioners in Florida who recently wrote to the state health department that evidence to support the use of those treatments in adolescents “is simply lacking” & asking that it be confined to research."

"Sweden is working to standardize adolescent transgender medical treatment and restrict it to research settings.

"Finland is also limiting treatment, more closely following the Dutch protocol, and doctors there remain concerned about the physical effects of blockers, including on brain development, said Dr. Riittakerttu Kaltiala, chief of adolescent psychiatry at a gender clinic in Tampere.

"As European countries continue to examine and tailor their treatment, in the United States the public discourse about transgender care is growing more incendiary.

"More than a dozen doctors declined to be interviewed for this article, and several who spoke to The Times — some who support treatment, others who question it — asked not to be named."

Curious about blockers, the brain & the European shift to caution on medicalised gender change for minors? Plenty of reportage here -- genderclinicnews.substack.com

Curious about blockers, the brain & the European shift to caution on medicalised gender change for minors? Plenty of reportage here -- genderclinicnews.substack.com