NHS bosses ordered to reveal fate of 9,000 young transgender Tavistock patients
Health Secretary demands full co-operation from trusts that refused to give information to Cass review

The NHS must reveal the fate of 9,000 transgender young people treated by the controversial Tavistock clinic, the Health Secretary has said in the wake of the Cass review.

The landmark report published on Wednesday found adult gender clinics had refused to disclose whether transgender people who started their treatment as children later changed their minds about transitioning, or went on to suffer serious mental health problems.

Victoria Atkins, the Health Secretary, met Amanda Pritchard, the chief executive of NHS England, on Wednesday to tell her “nothing less than full co-operation by those clinics in the research is acceptable”.

Writing in The Telegraph, Ms Atkins says she has had enough of “a culture of secrecy and ideology over evidence and safety”.

She goes on: “We simply do not know the lifelong impact of these medical interventions on young minds and bodies to be clear that they are safe.” Dr. Cass, in her report, expressed dismay that officials at NHS adult gender clinics refused to share with her team data pertaining to the 9,000 children seen in the pediatric clinic.

https://x.com/benryanwriter/status/1777834180744716360

🧵:Thoughts on the battle over the Cass Review:

1. Many are furious that systematic literature reviews, they say, set the bar too high, and forbid the acceptance of promising findings from studies on pediatric gender-transition treatment.

🧵See the thread for more🧵 2. Others say those standards of assessing the strength v weaknesses of research are vital to prevent research that makes false claims from impacting health policy. They note that the stakes are high, in particular giving drugs that may impact fertility and sexual function.

In the 2011 paper on the "Dutch model" that introduced pediatric gender-transition treatment to the world, the "foremost" explicit reason the authors pointed to for the apparent benefits of such treatment was so natal males could pass better as women.
academic.oup.com/jsm/article-ab…

https://twitter.com/fractionalgirl/status/1780253847652377025

However, as the Dutch model was modified with changing times and demographics of gender-distressed kids, the stated primary goals of such treatment shifted away from the appearance, and toward those tied to psychological functioning and the prevention of deaths by suicide.

🧵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. 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/…

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.

https://twitter.com/writingblock/status/1780333432234823803

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.

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 🧵⬇️ 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.

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 @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 🧵⬇️ 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…

I now understand how activist Alejandra Caraballo @Esqueer_ started the misinformation machine that got so many to believe the false claim that the Cass Review simply discarded non-randomized controlled trials. It's because Caraballo cited the *wrong* systematic lit reviews.🧵⬇️

https://twitter.com/benryanwriter/status/1779638396442313201

5 hours before the Cass Review was published on April 9, Caraballo tweeted a screenshot of what appeared to be the new systematic lit reviews that would published alongside Cass. But these screenshots were *actually* from the NICE reviews from 2020.

https://x.com/Esqueer_/status/1777755823743054120

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.

https://twitter.com/esqueer_/status/1777755823743054120

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.

https://twitter.com/benryanwriter/status/1779306273701339548

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🧵⬇️ 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.

Cass Review fact check, Part II:
The Puberty Blockers Paper

Many have claimed the systematic lit reviews on pediatric gender-transition treatment on which the Cass Review was based took 103 studies, tossed all but 2, and wrote their paper.

**This is false**

Learn more: 🧵⬇️ I previously showed how the systematic literature review on cross-sex hormones for minors actually included 34 high- and moderate-quality studies in its synthesis:

https://x.com/benryanwriter/status/1779165817482969298

There is a claim that only 0.2% of the limited sample of English pediatric gender clinic patients detransitioned. This is false. They have the denominator wrong. Detransitioners by definition have received hormones. 398 kids got hormones. If 8 detransitioned, that’s a 2% rate.

Here is the math:
▶️3,306 GIDS patients included in the analysis
▶️27% were referred to endocrinology: 584 natal females and 307 natal males = 891
▶️81.5% of them got blockers = 726
▶️54.8% of them got hormones = 398
▶️ 8 / 398 = 0.02, or 2%

There is a claim circulating that the authors of the systematic literature reviews of puberty blockers and cross-sex hormones for minors took 103 studies, threw out all but 2 for not being high quality, and then wrote their paper.

*This is false.*

To learn more see the 🧵⬇️ Let's look just at the review about cross-sex hormone use for gender dysphoria in minors. This analysis concerned 53 studies (the puberty blocker review looked at 50). No, the authors did not simply disregard all but the single study they deemed high quality. They examined all.

Major U.K. Report Finds Pediatric Gender Medicine Is Based on ‘Remarkably Weak Evidence’
Four years in the making, the report has firmly established new, cautious policies on treating youth gender distress in England, I report for @NewYorkSun. nysun.com/article/major-…

The final report of the Cass Review is out
England's National Health Service commissioned this independent review, by pediatrician Hilary Cass, of the nation's just-closed pediatric gender care clinic and the research backing pediatric gender-transition treatment.
Learn more🧵⬇️ The Cass Review characterizes the medicalized approach to pediatric gender-transition treatment—one that all major US medical societies support, and which is centered around the prescription of puberty blockers and cross-sex hormones—as unsupported by sound scientific evidence.🧵

No Charges in Death of Nex Benedict, Prosecutor Says

The Tulsa County district attorney said a fight involving the nonbinary student in an Oklahoma high school bathroom was “mutual combat.” The death has been ruled a suicide nytimes.com/2024/03/21/us/…

This AP article about the NHS ending routine puberty blocker prescriptions says, “leading health organizations in the United States and Europe continue to decisively endorse gender-affirming care for both transgender youths and adults,” before noting that the leading health authorities in England, Finland, Norway, Sweden and France have all moved to restrict pediatric gender-transition treatment. They all have done so not through political channels, but as a matter of health policy, in response to the systematic literature reviews to which U.S. medical groups and WPATH (which is essentially a U.S. medical group) turn a blind eye.

The article also cites WPATH misleadingly saying that puberty blockers have been safely used for 40 years. They have only been used for gender dysphoria outside of the Netherlands for 17 years, and only very sparsely until the mid-2010s, when gender dysphoria diagnoses started rising exponentially across the Western world. Also, people who start them for gender dysphoria almost always continue to cross-sex hormones. So they are more accurately thought of as the first step toward using hormones. washingtonpost.com/politics/2024/…

One of the things that makes it so hard for the public and journalists alike to wrap their heads around the subject of pediatric gender-transition treatment is that understanding it demands a ton of reading. I started reading intensively about it ~16 mos ago. These are my files. When I first started reading the literature about pediatric gender-transition treatment, I was constantly confounded, because highly learned people, I found, were publishing papers in which they’d say the exact opposite things from one another with equally forceful conviction.

I'm glad that Alejandra Caraballo agrees that posting someone's phone number counts as doxxing.

Because a year ago she posted my phone number in a tweet that got 2 million views and I was inundated with harassing phone calls and texts.

https://twitter.com/Esqueer_/status/1768074991042539622

This is the person who was grilled in a congressional hearing for tweeting calls for six Supreme Court justices to be routinely accosted in public and to "never know peace again."

I’ve lost track of the gay male academics who’ve recently tweeted at me sweeping and false accusations that I am guilty of egregious bias and hate toward a vulnerable group of people. Not one of these men has pointed to a specific fault in my reporting. They just call me names.

https://twitter.com/kastle1/status/1767725185036079324

Am I wrong to expect more from the public discourse of academics at universities? If they are men of Letters and Science, let them put pen to the page and point out how my own letters about science are faulty. If all they are capable of is derision and innuendo, I can’t pay heed.