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Benjamin Ryan Profile picture
@benryanwriter
Apr 15 • 16 tweets • 6 min read • Read on X
The @CBCNews quotes doctors repeating the false claim that the Cass Review disregarded any studies about pediatric gender-transition treatment that were not randomized controlled trials.

The article, by Lisa Johnson @LisaSJ, makes many other false claims.

See the 🧵⬇️ Image
The CBC article by @lisasj falsely claims that England has "decided to ban puberty blockers for youth outside clinical research." This is not a national ban. The NHS will no longer prescribe them. But kids can attempt to get them from private clinics. cbc.ca/news/health/pu…
The CBC quotes a doctor saying that "for the most part" puberty blockers are safe. But a recent review paper by Sallie Baxendale showed that the neuropsychiatric impacts of blockers are unknown. The new systematic lit review also identified many unknowns.
pubmed.ncbi.nlm.nih.gov/38334046/
Image
The CBC article by @lisasj claims that puberty blockers are "considered reversible." But both the new systematic literature review on these drugs and Baxendale's recent paper found that we don't know the answer to that question.
pubmed.ncbi.nlm.nih.gov/38334046/
adc.bmj.com/content/early/…
Image
The CBC article by @lisasj cites WPATH's guidelines on pediatric gender transition treatment. But the Cass Review and the University of York systematic literature review indicated that WPATH's guidelines are of low quality.
The @CBCNews article by @LisaSJ falsely suggests that the systematic literature review about puberty blockers on which the Cass Review was partly based judged studies in particular on whether they were randomized. Not so.
Image
Where did the false claim about the Cass Review's attitude toward randomized controlled trials come from? I believe I have the answer here:
To learn more about how much is unknown about the safety of puberty blockers when used for gender dysphoria in adolescents, see:
To learn more about that the new systematic literature review on puberty blockers did and did not say or do, see:
To read about the specifics of the Cass Review, see:
To learn more about how the Cass Review and its supporting systematic literature reviews processed the available research see:
A recent preprint study out of the Mayo Clinic found evidence that puberty blockers used for gender dysphoria are associated with substantial testicular atrophy.
Want to learn more about how much is unknown about the safety of puberty blockers when used in adolescents for gender dysphoria, check out the video of Sallie Baxendale's presentation at the @SEGM_EBM conference in October, which I attended in NYC.
@segm_ebm

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More from @benryanwriter

Benjamin Ryan Profile picture
Apr 16
🧵Study: Most Elite Female Athletes Want Sports Segregated By Biological Sex

A survey of 175 national, elite and world-class athletes eligible to compete in women's sports found 58%--and 75% of world-class athletes--thought it unfair for trans women to compete in women's sports. Image
The new study, which found that most advanced women athletes think it unfair for trans women to compete against them, is the largest of its kind. It included 26 world champs, 22 Olympians and six paralympians.
eurekalert.org/news-releases/…
Image
🥇New study🥇
“The perspective of current and retired world class, elite and national athletes on the
inclusion and eligibility of transgender athletes in elite sport”
dx.doi.org/10.1080/026404…
Read 10 tweets
Benjamin Ryan Profile picture
Apr 16
WPATH responds to the Cass Review, which lambasted them for, it said, exaggerating the strength of the evidence behind its guidelines and citation “circularity”. WPATH dismisses Cass as based on a “false premise” that non-medical means are best for most kids with gender distress.
Put another way, WPATH is arguing that the majority of children with gender dysphoria will do best if provided puberty blockers and cross-sex hormones.

According to the Williams Institute, an estimated 300,000 Americans 13 to 17 year old identify as transgender.
Read 6 tweets
Benjamin Ryan Profile picture
Apr 16
What the Cass Review Says About Detransitioning
First and foremost, Cass says: "The percentage of people treated with hormones who subsequently detransition remains unknown due to the lack of long term follow-up studies."

But what else❓

Read the 🧵⬇️Image
What is detransitioning?
The Cass Review says it's someone who took cross-sex hormones, then stopped and reverted to identifying as their natal sex. Cass says that clinicians told her that some people take 5-10 years to detransition. So much follow-up time is needed to assess.Image
One of the Cass Review's key points is that detransitioners need support. Image
Read 15 tweets
Benjamin Ryan Profile picture
Apr 16
England’s Health and Human Care Secretary @VictoriaAtkins responds to the Cass Review.

She says part of the NHS “was overtaken by secrecy and ideology that was allowed to trump evidence and safety.”

She vows to stop all puberty blocker prescriptions.
The status of children’s access to puberty blockers in England:
▶️NHS doctors may not prescribe them.
▶️Private clinics technically may, but none are officially sanctioned to and the government seeks to crack down.
▶️The govt also seeks to crack down on overseas prescriptions.
The NHS is supposed to launch a puberty blocker trial. But it needs ethical clearance. At the earliest, it might start early next year. The Cass Review strongly suggested it will only be open to children whose gender dysphoria started in early childhood.
Read 4 tweets
Benjamin Ryan Profile picture
Apr 14
The 1st person to falsely claim that the Cass Review “disregarded nearly all studies” about pediatric gender-transition treatment was apparently activist Alejandra Caraballo. She claimed this 5 hours before the Cass Review was published on April 9, before she’d actually seen it.
Caraballo’s claim about the Cass Review is false, as I demonstrated in this thread. The thread has been added as evidence backing the Community Note placed on English singer @BillyBragg’s false claim about the review, which echoes Caraballo’s.
@billybragg I know Caraballo did not have access to the Cass Review’s final report before the embargo lifted (at 7:01pm ET April 9), because shortly before the embargo was set to lift, she tweeted what she thought was the Cass report. But the link was to the review papers, not the report.
Read 8 tweets
Benjamin Ryan Profile picture
Apr 14
Claims that the Cass Review discarded 101 out of 103 studies of pediatric gender-transition treatment are:

🚨FALSE🚨

Let's examine how Hilary Cass and her team *did* factor in the systematic literature reviews about puberty blockers and cross-sex hormones:

Check out the🧵⬇️Image
Many of you have seen the tweet threads I've posted since Friday night outlining how the investigators at the University of York conducted their two systematic literature reviews on pediatric gender-transition treatment. I link to those threads in the next two tweets. Image
One systematic literature review examined puberty-blockers for gender distressed kids. It examined 50 studies, and included in its synthesis one high-quality study and 25 moderate-quality studies.

It did not simply ignore the 24 low-quality studies.
Read 22 tweets

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