Since 2017, during a moral panic, too many UK Trans youth have died waiting for Gender Services or CAMHS. For many, state failures were a factor in their deaths. It is vital we learn from, & discuss their deaths responsibly. This thread is my attempt to do so CW: Death Suicide 1/ Before discussing individual cases it is important to know that there is rarely one cause for suicide. All deaths by suicide are avoidable & there is always help available if you need it.
Samaritans - 116 123
Papyrus - 0800 068 41 41 (Text 07786 209697) Childline - 0800 1111 2/

Today the Government has published a "Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust: independent report" by @ProfLAppleby. It is published in the context of a public discussion on suicide in relation to access to puberty blockers. 1/ This review is based upon two data sources: 1) Tavistock and Portman NHS Foundation Trust audit. 2) National Child Mortality Database (NCMD). It would be helpful for these sources to be published alongside the report in order that it be "open to independent scrutiny" 2/

Some important questions from @CatSmithMP here to the Department of Health. I look forward to @wesstreeting's responses. On Q262 (comparative assessment against other European countries) I can imagine he will refer to the Cass/ York's Systematic Review. However... 1/

https://twitter.com/ReactiveAshley/status/1813971362480103577

As demonstrated by Yale Law School "Evidence-Based Critique of “The Cass Review” this failed to adhere to key components of a SR - "standardized and rigorous process that assesses quality of the entire body of evidence". York's paper on Clincal Guidelines is particulalry poor 2/

1. Puberty blockers have been used in Trans health since the 1980s the same as for precocious puberty. There is 40+ years evidence that this treatment is effective. With no recorded instances of serious harm.
2. Cass Review did not compare use of blockers in PP and Trans health.

https://twitter.com/wesstreeting/status/1812436959656075705

The Cass Review provides no strong evidence that puberty blockers impact phychological and brain development. This is hypothesis and conjecture from a cis-supremacist position. Being Trans is not a bad outcome.

In 1981 Stephen, a 14 yr old Trans boy in Pittsburg found a psychiatrist who would listen & asked for a 'sex change'. The psychiatrist spent 5 months analysing Stephen, & decided rather than provide hormone treatment he would prescribe anti depressents.. CW next tweet suicide 1/ Therapy' & antidepressents made things worse. Stephen had a number of suicide attempts immediately before or during menstruation. The psych to his credit, realised his treatment wasn't working & contacted an endocrinologist with experience working with 'Transsexuals' 2/

Trans people have been using hormones for healthcare for around 100 years. There is 100 years of experience of Trans people helping each other source medication & use it as safely as possible working with health providers where possible in a 'least harm' approach. 1/ Under the current UK Government & NHS there is no access to adolescent healthcare. I believe there is a moral duty to help Trans youth who are accessing medication to do so as easily & as safely as possible. To highlight & mitigate the risks, & provide trusted information 2/

BREAKING -SEGM "The most prominent of the pseudo-scientific organizations in the anti-trans space", met with US Department of Health in April 2022. The minutes of the meeting state SEGM's Richard Byng & Richard Stephens are members of the NHS Working Group on Gender Dysphoria 1/

The NHS Working Group on Gender Dysphoria is the group that advised the Cass Review. The membership of this group has been kept secret by Cass. Now we know why. With Byng & Stephens, & Riittakerttu Kaltiala, we now know at least 3 members of SEGM were advising Cass. #CassFlaws 2/

The question whether the Cass review team carried out engagement with Trans communities is immaterial. The engagement was not genuine, views shared in good faith by children & young people, families & support services were absent from synthesis & final recommendations. #CassFlaws

https://twitter.com/ErinInTheMorn/status/1783848350355226660

The methodology of the Cass Review qualitiative research stated they would conduct 40 interviews, 20 with 12-18s and 20 with adults up to age 30. They managed only 14 and 12 respectively. 26 interviews which were jumped on by gender critcal parents & anti Trans 'ex trans' groups

I'm working my way through the Cass Sytemic review on Clinical guidelines for children & adolescents experiencing gender dysphoria or incongruence: it is very difficult to lack of access to the standards they review. There are also methodological issues 1/adc.bmj.com/content/early/… I'm going to talk about the two standards the Cass research team rated highest & which the Cass Final report is most closely matched to in terms of recommendations - namely The Swedish and Finland protocols 2/

I've been looking at a paper cited in Cass (recreating a graph introducing new spelling errors). I have thoughts. It is an undergraduate author. No full is data provided - only 3 sets of extracts, which have 9 or 10 respondents 1 of which repeats in error. tandfonline.com/doi/full/10.10…
The methodology section doesn't state the survey was originally a questionnaire to understand current needs of detransitioners and to produce an information booklet about detransition. I wonder if ethics approval was given for this - any German Trans academics can help check?

I've been reading of the Finland youth gender centre in Tampere which the Cass review lauds. It was recently revealed the head of the centre is on the Cass advisory group. CW In following tweets I relate extremely disturbing accounts from parents & youth of what they endured 1/ This is by 'Spinner' for Kehraaja (Nightjar in Finnish) 19.3.2021 "Describe to me how you masturbate?" - the position of trans youth in the treatment system is bleak" 2/kehraaja.com/kuvaile-minull…

There is a bad science story in Today's Daily Mail. Where an anti Trans academic has published a new study - the headline claiming Puberty Blockers lowers IQ in Trans youth. It took me 5 mins to find the study.
Here's some quick fact checking on this research: 1/ 1) The study 'The Impact of Suppressing Puberty on Neuropsychological Function' Baxindale S. is pre-print & has not been peer reviewed. It is not clear where or when it will be published. A quick review sees some common factors in anti Trans studies such as 'cherry picking' 2/

BREAKING: WPATH release statement on NHS Trans health interim service specification for children & young people "An unconscionable degree of state intusion into personal & family medical decision making" with "serious flaws...likely to cause enormous harm"
#TransHealthCrisis WPATH, ASIAPATH, EPATH, PATHA, and USPATH Response to NHS England Statement regarding the Interim Service Specification for the Specialist Service for Children and Young People with Gender Dysphoria (Phase 1 Providers) by NHS England* listloop.com/wpath/mail.cgi…

If a post adolescent Trans young person can give consent, has both support at home and from their medical team, then there should be a route to gender surgeries where that young person wants and understands the treatments involved. I'm very glad WPATH SoC8 gives space for this. For those who criticise this opinion, I'd reply that other people's medical care is none of your business. That these are personal decisions which are carefully considered by the people best placed to make them. Body autonomy is a human right.

Reminder that Puberty blockers were first used for trans health in 1988. The adolescents who received them, in the Netherlands, are now in their late 40's & doing great according to decades of follow up studies. This treatment is not experimental it is evidenced best practice. This piece by @FierceMum summarises much of the recent literature on puberty blockers, their effectiveness & other impacts growinguptransgender.com/2020/06/10/pub…

"We need more research about Transgender children" is the claim (by those who argue against Trans healthcare).

Well, here's just some of the research that's been carried out in the last 5 years supporting the finding that Trans healthcare is healthcare THREAD: 1/ Mental health and self-worth in socially transitioned transgender youth. Journal of the American Academy of Child and Adolescent Psychiatry, Durwood, L., McLaughlin, K. A., & Olson, K. R. (2017) doi.org/10.1016/j.jaac… 2/

The Equality Act 2010 is the main reason why you have heard of Trans children. Before it was in place, there were no protections to allow children who were Transgender to be recognised or protected at school & in society. 1/ While there were legal protections for adults for example in employment & in healthcare, for Trans children & young people, only from 2011 onwards (when the act came into force) were they recognised in the protected characteristic of gender reassignment & legally protected 2/

I am the parent of a Trans child & I will not be accused
of homophobia, especially by Ex GIDS psychoanalysts (the 'profession' which industrialised conversion therapy). You clearly no nothing about us, our children or Trans people, you pernicious, moral panic instigating hacks. The accusations come via testimonies of a now former clinician of GIDS (NHSEngland's Children's Gender Identity Development Service), these were compiled in a report by David Bell & leaked to various newspapers including the Telegraph & Observer. The report's never been published

I've asked doctors, in which circumstances would it be medically necessary for our child or parent to disclose her sex assigned at birth when seeking medical help. The specific circumstances are vanishingly small. Enforced disclosure leads to distress & risks harm & prejudice

https://twitter.com/NotRightRuth/status/1360545633086676993

The one time we disclosed, when unsure, lead to invasive, unnecessary questioning regarding genitalia by NHS staff, entirely unrelated to the purpose of visit. Our daughter's NHS marker states female & we've made decision as a family in future to not disclose unless essential.

"Puberty blockers" were first used for transgender health in 1988. The adolescents who received them, in the Netherlands, are now in their mid 40's and doing great according to over 20 years of follow up studies. This treatment is not experimental it is evidenced best practice. Dulcan & Lee treated a trans male youth aged 17 in 1982. "Although Steven might be considered by some to be too young to begin hormone treatment, the prospect of waiting yet another year, or longer, was unbearably painful for him" CW: medical transphobia jaacap.org/article/S0002-…

I don't know who needs to hear this today, there are literally thousands of happy children & young people in the UK who happen to be transgender. They're loved by families & friends. They're supported to be who they are in school, university & work & they're doing amazing. This is not to dismiss the inequalities that exist for trans people. Things can seem bleak when our media & our Government are determined to spread fear & mistrust, However they cant stop trans people who are changing the world, simply by living their best lives. #transkidsliving